Ramström: Tobacco Harm Reduction Works

    Photo: Finn Bjurvoll Hansen

    A new study launched at the ninth annual Global Forum on Nicotine  in Warsaw shows implementation of the World Health Organization’s tobacco control measures known as MPOWER has no clear association with low-levels of tobacco-related mortality in Europe.

    Instead, the independent research, conducted by Lars M. Ramström, shows that switching from smoking to Swedish-style snus, a safer nicotine product, is a more effective strategy to reduce the harms caused by tobacco.

    In 2007, the WHO launched MPOWER, a process and monitoring mechanism to implement the Framework Convention on Tobacco Control. Comprising six measures, it aims to reduce the demand for tobacco. But, despite 15 years of MPOWER, there are still 1.1 billion smokers worldwide, a total unchanged since 2000, and 8 million annual tobacco-related deaths, according to researchers.

    To assess MPOWER’s effectiveness, Ramström compared the extent of implementation of these tobacco control measures with tobacco-related death rates across Europe by using figures provided by the Tobacco Control Scale (TSC), a tool that grades every European country’s level of MPOWER application, and data on tobacco-related mortality from The Global Burden of Disease.

    After analyzing his results, Ramström found no correlation between tobacco-related mortality and a country’s level of implementation of MPOWER measures for Europe’s women, and a very weak correlation for the continent’s men.

    Crucially, though, the two countries with the lowest tobacco-related mortality for men were Sweden and Norway. In both nations a large proportion of male smokers have switched from cigarettes to Swedish-style snus, a product that is freely available in both, but banned from sale in the EU except Sweden. Despite Sweden’s TCS score being below average, it has achieved a lower rate of tobacco-related mortality than all the countries that have higher levels of MPOWER implementation except Norway, providing further evidence in support of tobacco harm reduction.