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Due to declining smoking rates, Sweden has the lowest mortality from all cancers among men in the EU and an overall cancer incidence that is 41% lower than the EU average, offering a stark contrast to Africa
Across Africa, smoking-related diseases continue to place a heavy burden on public health systems, with cancer rates rising despite decades of traditional tobacco control measures. While many countries have focused almost exclusively on abstinence-only approaches, global evidence shows that this strategy alone is not enough to reduce smoking-related harm rapidly.
Each year, World Cancer Day takes place on February 4. For us, it is an opportunity to spread knowledge about what can be done so that fewer people are affected by cancer and to highlight policies that are already delivering real-world results.
Sweden offers a compelling alternative. By embracing tobacco harm reduction, encouraging smokers who cannot quit to switch to significantly less harmful nicotine products, Sweden has achieved the lowest smoking rates in Europe and some of the lowest tobacco-related cancer rates. Sweden’s science-backed harm reduction policies have slashed smoking rates by 54% since 2012, reaching just 5.3%.
This progress was not driven by prohibition, but by pragmatic regulation, consumer choice, and access to safer alternatives. Accurate risk communication and proportionate regulation have helped smokers move away from combustible cigarettes, where the vast majority of smoking-related cancers originate.
Africa faces unique challenges, including widespread illicit trade, limited cessation support, and weak enforcement capacity. Replicating punitive policies without viable alternatives risks pushing consumers into unregulated black markets, worsening health outcomes. Sweden’s model shows that regulated access to safer products, combined with truthful public information, can accelerate declines in smoking while undermining illicit trade.
If African policymakers are serious about reducing cancer-causing smoking, the lesson from Sweden is clear: evidence-based harm reduction works. Adapting this proven blueprint to African realities could save millions of lives, reduce cancer rates, and deliver faster public health gains than the status quo.
By Joseph Magero
