Towards Tobacco-Free Generation: implementation of preventive tobacco policies in the Nordic countries

Abstract

Aims: Europe’s Beating Cancer Plan set a goal of creating a Tobacco-Free Generation in Europe by 2040. Prevention is important for achieving this goal. We compare the Nordic countries’ preventive tobacco policies, discuss the possible determinants for similarities and differences in policy implementation, and provide strategies for strengthening tobacco prevention. Methods: We used the World Health Organization Framework Convention on Tobacco Control (WHO FCTC) to identify the key policies for this narrative review. We focused on Articles 6, 8, 9, 11, 13 and 16 of the WHO FCTC, and assessed the status of the required (core) and recommended (advanced) policies and their application to novel tobacco and nicotine products. Information on the implementation of strategies, acts and regulations were searched from global and national tobacco control databases, websites and scientific articles via PubMed and MEDLINE. Results: The WHO FCTC and European regulations have ensured that the core policies are mostly in place, but also contributed to the shared deficiencies that are seen especially in the regulations on smokeless tobacco and novel products. Strong national tobacco control actors have facilitated countries to implement some advanced policies – even as the first countries in the world: point-of-sale display bans (Iceland), outdoor smoking bans (Sweden), flavour bans on electronic cigarettes (Finland), plain packaging (Norway), and plain packaging on electronic cigarettes (Denmark). Conclusions: Collaboration and participation in reinforcing the European regulations, resources for national networking between tobacco control actors, and national regulations to provide protection from the tobacco industry’s interference are needed to strengthen comprehensive implementation of tobacco policies in the Nordic countries.

The role of the state in consumer culture: the case of “Operation Vin” in Sweden

“…In essence, the Swedish government has used their soft power approach to grow a consumer culture of wine consumption in Sweden. This soft approach is quite different from the approach taken by the state in order to change the Swedish citizens smoking habits where hard measures, especially in comparison with other European countries, were taken (Linnansaari et al, 2022). Since there is relative consensus regarding the negative effects of cigarette smoking and since it is not entangled in so many other cultural practices in Sweden, the state has greater degrees of freedom to enforce such hard measures.…”

Have the recent advancements in cancer therapy and survival benefitted patients of all age groups across the Nordic countries? NORDCAN survival analyses 2002-2021

“…Although the distribution of histological subtypes of lung cancer are fairly similar across the Nordic countries, a higher proportion of 'unknown subtype' is registered in Finland (unpublished data). Tobacco control policies have been implemented in the Nordic countries and have likely impacted on lung cancer incidence and major lung cancer subtypes across countries [37]. Yet differences in smoking patterns, smoke-less tobacco use and cessation advice, in addition to implementation of treatment guidelines and patient pathways, may have influenced the survival differences between the countries [38].…”

The association between health literacy and e-cigarette use: evidence from Zhejiang, China

“…The field investigation officially began in September 2022 and was completed by the end of November 2022. Sampling methods were carried out in accordance with national guidance ( 25 ), which was divided into the following four steps: ( 1 ) each county (city, district) adopted stratified multistage probabilities proportional to the population size (PPS) sampling frame to select four townships; ( 2 ) each township adopted a PPS sampling frame to select two communities (villages); ( 3 ) 100 households were selected from each community (village) by random sampling; and ( 4 ) one participant from each household was selected for a face-to-face interview using Kish’s grid ( 26 ). At least 80 participants were required to complete the questionnaire for each community (village).…”