By David Arome
Smoking remains one of the leading preventable causes of death, claiming over 8 million lives globally each year, according to the World Health Organization. With more than 18 billion cigarettes sold each year, smoking has become woven into Nigeria’s social fabric, leaving behind a trail of addiction, illness, and death. Yet amid this reality, a new question is emerging: can tobacco harm reduction offer a lifeline?
Sweden was officially declared the world’s first smoke-free country on November 13, 2024, after reducing its smoking rate to just 5.3%, meeting the global benchmark that defines a nation as smoke-free. But the question remains: can Nigeria chart a similar path?
This question took center stage at a one-day event in Abuja, Nigeria, themed “Can Nigeria Quit Like Sweden?”, where public health experts and advocates gathered to chart a new course toward a smoke-free future.
At the heart of the discussion was tobacco harm reduction (THR), a people-centered idea that recognizes an important truth. “While complete abstinence from nicotine may be ideal, not everyone will take that path. For those who do not, less harmful alternatives can save lives,” Pharmacist Yusuf Adebayo of the Africa THR Research Hub explains.
“Harm reduction is helping people, not punishing them. The spirit behind the Swedish experience is recognizing that people are different,” Suely Castro, Director of Quit Like Sweden, added.
Suely provided further insight into the Quit Like Sweden experience, an approach centered on tobacco harm reduction. This strategy enables people to have alternatives that are accessible, affordable, and acceptable. Nicotine pouches, she explained, have helped many people in Sweden reduce smoking rates drastically. Since their introduction, there has been a significant decline in smoking prevalence among those who use the nicotine pouches.
Suely maintained that Nigeria’s diversity requires adaptation, not imitation. “Nigeria is a very diverse country. We cannot copy and paste the Swedish approach into Nigeria, but we can learn from it. No policies can be transported, copied, or pasted in any country because every country has its peculiarities,” she said.
Although cultural differences exist between Nigeria and Sweden, experts agreed that valuable lessons can be drawn from Sweden’s approach and adapted to Nigeria’s realities.
Pharmacist Yusuf emphasized that THR is a proactive measure that provides smokers with options to less harmful tobacco products. “It’s about respect for people, not making them feel harm,” he said. He further explained that people smoke for nicotine, not tar, noting that tobacco contains over 7,000 harmful substances, most of which are linked to cardiovascular diseases.
Tobacco harm reduction, Pharmacist Yusuf added, challenges old certainties, shifting the focus from blame to better choices, from punishment to prevention.
“THR is not a conquest, but a strategy, a continuous effort to minimize health consequences through safer options,” said Chuks Akamadu, President of the Center for Ethical Rebirth among Nigerian Youths and representative of the Director General/CEO of Nigeria Raw Materials Research and Development Council (RMRDC). He stressed that harm reduction in Nigeria must be seen as a work in progress, one that should be streamlined into locally driven solutions reflecting the country’s unique social and cultural contexts.
For Uche Olatunji, Convener THRNigeria, the key lies in understanding the broader picture. “To better understand THR, it is good to make people grasp the overall concept of harm reduction before focusing on specific areas like tobacco, drugs, and mental health,” he noted.
He also called for stronger engagement between the media, advocates, and public health practitioners to champion the tobacco harm reduction conversation and bring it closer to the public. According to him, creating spaces for such dialogue can help deepen understanding and disseminate accurate information on tobacco harm reduction.
On the economic aspect of tobacco harm reduction, Uche noted that advocates’ primary focus should be on saving lives. “If people are already using tobacco, we need to offer them safer alternatives like electronic cigarettes, snus, or nicotine pouches. By making these options available, people can make healthier choices while still supporting livelihoods connected to the tobacco market,” he explained.
He further stressed, “What’s more important is for people to have alternatives or make decisions that will benefit them and not die from smoking-related diseases.”
Dr. Tatah Eunice, a public health specialist, shared a similar view. “What worked in Sweden is not necessarily what might work in Nigeria. What this means is looking at those strategies that helped Sweden switch successfully and fine-tuning them into the Nigerian context,” she highlighted.
Dr. Eunice emphasized that young people are often the most vulnerable to tobacco use, which is why they should be actively involved in tobacco harm reduction efforts. By engaging them in awareness programs and educational activities, they can better understand the risks of smoking, the importance of quitting, and the value of safer alternatives for those who struggle to stop.
The potential health benefits of implementing the Swedish experience in Nigeria are promising. “We hope that one day Nigeria can have as low a smoking prevalence as Sweden does and have fewer smoking-related diseases,” Suely stressed.
As Nigeria grapples with rising tobacco use and its devastating health consequences, the lessons from Sweden’s harm reduction journey offer a hopeful roadmap. The path to a smoke-free future will not come from imitation but innovation from rethinking tobacco control through empathy, evidence, and inclusion.