Sweden has found nicotine alternatives are better way to kick smoking
When the city of Brookline passed a generational ban on tobacco products in 2020, it was an extraordinary legal maneuver. The age-gating of goods on an incremental level prevents anyone born after January 1, 2000 from buying any tobacco-related products within city limits.
It is a policy dreamed up by many in public health who have sought to replicate it elsewhere, including in New Zealand, Malaysia, and, now, the UK.
Now, however, a constitutional challenge in the Massachusetts courts is revisiting whether the health ordinance is legal to enforce. And it’s about time.
Despite already increasing the age limit to purchase tobacco from 19 to 21 and banning flavored tobacco products throughout the state, proponents are claiming that a full generational ban is a sure-fire way to eliminate youth use. But we know it isn’t, as the numbers already show us.
While it shouldn’t need restating, prohibition never works. In 2020, Massachusetts became the first state to ban all flavored tobacco products, again in effort to curb youth use. However, according to the Massachusetts Illegal Tobacco Task Force, the ban resulted in increased interstate smuggling of tobacco products, more tobacco-related police interactions, and a loss in tax revenue for the state.
Ultimately, the flavor ban did not eliminate consumer use of flavored tobacco products. It just shifted where consumers purchased their goods. Which means the estimated 587,000 adults who smoke in Massachusetts likely had to turn to alternative sources to purchase tobacco products they prefer.
When a product is banned, then consumers often go to the illicit market to find their desired products. This poses great concern, as the illicit market does not have to abide by product regulations and certainly is not performing age verification on purchases.
California followed in Massachusetts’ footsteps by banning flavored tobacco products in 2022, and further saw an extreme increase in the illicit market where brands known to be trafficked in by Mexican cartels. This suggests that tens of millions of packs are illegally entering California. It’s doubtful that this is the public health “win” tobacco control activists are looking for.
While Brookline is the first in the US to pass a generational tobacco ban, there are international examples of similar policy. Both New Zealand and Malaysia have attempted to implement a generational tobacco ban, but have since pulled back after backlashes showed up in polling and disagreements over taxation. The Conservative government in the United Kingdom has plans to implement such a ban, but has also faced severe backlash from its more liberty-oriented grassroots.
Rather than put all our cards on failed generational policies, it would be better to look globally towards policies that have helped reduce smoking prevalence. Sweden is a great example, as the World Health Organization announced that they are likely to become the first smoke-free country.
Interestingly, Sweden is not succeeding using bans and prohibition, but rather through the concept of harm reduction. The Swedish government has recognized that nicotine alternatives, such as vaping, nicotine pouches, and snus, are significantly less harmful than smoking combustible tobacco and have therefore encouraged its citizens to make the switch. As a result, Sweden reduced its smoking rate by 55 percent in the last decade and has the lowest incidence of cancer within the European Union.
While the desire to reduce youth use of tobacco products and overall smoking prevalence is a noble and important goal, it will be imperative that policymakers understand the serious unintended consequences of prohibition.
As other countries have shown us, embracing tobacco harm reduction, not prohibition, will be the best strategy to improve public health in Massachusetts. That’s a great idea in any generation.
Originally published here