Folkhälsominister, Sjukvårdsminister och IdrottsministerStatsrOne of our coalition government’s most important goals is to close the health gaps that can be influenced within the space of one generation. Achieving that ambitious goad will require great effort in several areas, public health not least.

A 2014 report by the National Board of Health and Welfare — Registeruppgifter om tobaksrökningens skadeverkningar [Official Data on the Harmful Effects of Smoking Tobacco]— presented evidence that around 800,000 Swedes became seriously ill during the past eight years due to smoking. Nearly 100,000 individuals died of the same causes. In connection with international efforts to reduce the frequency of so-called non-communicable diseases, tobacco use has been specifically cited as one of the four most serious risk factors. Other factors include alcohol, unhealthy diet and inadequate physical activity — all of which are clearly linked to various socio-economic circumstances.

Despite all this, no new initiatives have been taken to reduce smoking since the latest major reform of tobacco policy, the introduction of a ban on smoking in pubs and restaurants. That reform was implemented ten years ago by the Social Democratic government then in power, under the supervision of Minister of Public Health Morgan Johansson and in co-operation with the Green and Left parties.

After ten years, it is now time to take additional measures in the area of tobacco use prevention.

”Tobacco Endgame — Smokefree Sweden 2025” is an opinion-building project operated by a number of organizations that work with tobacco prevention. The purpose of the project is to agree on a target date for a dramatic reduction of smoking, when it will no longer be a major public health problem.

Governments and legislatures in other countries have set final dates for tobacco use and are developing strategies to phase it out. Ireland has adopted a plan to be smokefree by 2025, New Zealand has chosen the same year as its target date, and Finland has decided to become smokefree by 2040.

Our government approves both a public appeal for and the goal of a smokefree Sweden by year 2025. But strong measures are required to achieve that goal.

The government’s special investigator in this matter, Göran Lundahl, submitted his report two weeks ago. It includes proposals for changes in the law which are necessary due to recent revisions to the Tobacco Products Directive of the European Union. A major step forward in the EU’s tobacco prevention efforts, the Directive is intended to make tobacco products and their use less attractive. Young people comprise the most important target group, since most smokers start using tobacco during their teenage years.

However, the ambitions of our coalition government are not limited to making necessary changes to the law. We are therefore adding three additional instructions to the brief of the special investigator:

1. Restrictions on smoking of tobacco and tobacco-related productsin certain public places

Smokefree environments protect non-smokers from the risks of passive smoking. Such environments also give support to those who want to quit smoking, result in fewer cigarettes being smoked, and lower the risk of relapse among those who have already quit.

In 2012 the Swedish Public Health Agency was assigned the task of investigating and assessing the possibility of providing for future smokefree environments in public places where smoking occurs, and in particular those where children are present. The conclusion was that there are good reasons for legislation on smokefree outdoor public places as part of a comprehensive tobacco prevention programme. Such places include entrances to buildings that are publicly accessible, public waiting areas for mass transit, outdoor dining facilities, playgrounds, and outdoor arenas and sports facilities.

Our government will therefore instruct the special investigator to analyse and assess the need for regulations or other measures to restrict smoking of tobacco and tobacco-related products in certain public places, as per the Public Health Agency’s proposals.

2. Ban on exposure to tobacco products

Such a ban would require that tobacco products be stored out of sight of consumers, for example in cabinets under sales counters. Studies and the experience of countries that have introduced exposure bans indicate that such measures change general attitudes toward tobacco, and also reduce consumption and the proportion of impulse purchases. Especially affected are young people’s attitudes, habits and willingness to experiment with tobacco. Individuals who smoke have said that banning exposure to tobacco products would make it easier for them to quit smoking.

Exposure bans have been introduced in several countries, including Australia, Finland, Ireland, Canada, Norway and the United Kingdom. Such bans are recommended by the World Health Organization’s Framework Convention on Tobacco Control. Given that background, the current government believes that there is good reason to introduce a ban on exposure to tobacco products in Sweden.

3. Plain tobacco packaging

This refers to packaging without any decoration except the same neutral colour, regardless of manufacturer, and with the trademark printed with the same neutral typeface. Research indicates that these requirements can make products less attractive and tobacco use less socially acceptable, especially among young people, and also make it easier to quit smoking.

In 2012 Australia became the first country to require plain packaging. It is a measure that has met with resistance, and is still the subject of international legal proceedings within the framework of the World Trade Organization. However, both Ireland and the U.K. — citing the recently revised EU Tobacco Products Directive — have announced that they intend to move ahead with plans to introduce plain tobacco products packaging, without waiting for the outcome of the WTO proceedings. A number of other countries have expressed interest in following the example of Australia, Ireland and the U.K. on this issue.

Against that background, our government has concluded that there is an urgent need to investigate the possibility of requiring plain tobacco products packaging in Sweden.

The additional instructions that will be given to the government’s special investigator are far-reaching. But they are also necessary if Sweden is once again to take a leading role in the work of tobacco use prevention. We must have high ambitions if we are to achieve the goal of closing health gaps that can be influenced. Creating a smokefree society is an important component of that work.

Gabriel Wikström,Minister for Health Care, Public Health and Sport,Government of Sweden

•Originally published in the Swedish daily newspaper, Dagens Nyheter. Translated from Swedish by Al Burke, at the request of Tobaksfakta – oberoende tankesmedja.

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