Officials plan to make Finland tobacco-free by 2040, meaning they want less than 2% of their adults to consume any form of tobacco. The Finnish government’s ambitious goal for residents is in an effort to improve public health, and save costs.
Smoking rates in Finland, and the rest of the developed world, have been on the decline in recent decades due to measures such as bans on advertising and shop displays, and the creation of smoke-free public spaces. In 2013, 16% of 15- to 64-year-olds in Finland smoked on a daily basis, while nearby in the UK, 19% of adults were smokers in 2014.
“The Finnish approach is revolutionary,” said Kaari Paaso, head of the unit on harm prevention at the country’s Ministry of Health and Social Affairs. “We want to get rid of all tobacco products.”
Experts agree that the Finnish government is using innovation and creativity to get everyone to kick the habit. Rather than targeting one area at a time, such as exposure in public spaces or cigarette use, Paaso said his ministry wants to be precautionary from every angle. It doesn’t go down the path of advocating milder products that may do less harm, such as e-cigarettes or snuff.
Sweden has also seen a dramatic reduction in the number of smokers, just 12.7% among men and 15.2% among women in 2013, but achieved this in part by promoting the use of snus, an oral smokeless tobacco product. The product, along with all other forms of oral tobacco, is banned in other member states of the European Union.
The UK is also adopting a harm reduction approach to reduce the number of smokers. Instead of snus, it backs the use of e-cigarettes to help people kick the habit. But Finland wants rid of it all.
“We don’t want to fall into the trap of other policies that have less harmful products,” said Paaso, who fears that promoting other products will result in a new addiction for health officials to deal with in the future.
Experts agree that one of the strongest policies in terms of tobacco control globally has been taxation. The rising cost of the habit, linked to higher taxes, has meant that many can no longer afford to smoke, and those who can smoke provide revenue for anti-smoking campaigns and quitting support services, to name a few options.
So Finland has now introduced another giant financial barrier for users: It increased the costs for vendors selling tobacco products. Any business wanting to sell tobacco must first apply and pay for a license, a one-off process, but an additional fee must be paid annually to cover the costs of surveillance officers in each municipality who will check that retailers are following the rules.
“Finland has come very far … and now they’re going to the next level, with innovation,” said Kelly Henning, director of the public health program at Bloomberg Philanthropies, an organization working to promote impactful tobacco control policies, founded by the former New York mayor.
Henning highlights that the World Health Organization’s Tobacco Free Initiative has six steps it recommends for effective control, known as MPOWER. The last letter stands for “Raising taxes on tobacco.”
Another unique approach the Scandinavian country implemented this month was the ability to apply for a ban on people smoking on neighboring balconies if their presence is a disturbance.
Housing companies may now apply for the ban if smoke is seen to be spreading from someone’s private balcony and onto other spaces. As in many other countries, bans are in place in public areas, but this new policy addresses a smoker’s private space.
One key strategy in Finland’s approach to eradicate smoking is reducing the number of teenagers picking up the habit in the first place, by reducing its presence and its appeal. As a result, new policies also limit the purchase of products that imitate tobacco or cigarettes, such as sweets and chocolates shaped as pipes or cigarettes. Though these products aren’t banned, they face restrictions.
As of August, e-cigarettes had the same restrictions in terms of sales and public use as regular cigarettes, such as age limits, and they are no longer allowed to have any flavors. “They cannot have any distinctive taste,” Paaso said, adding, “our approach is this basic idea to phase out all nicotine products.” The use of flavors in e-cigarettes has been the subject of much debate, amid fears that they will entice young people toward the habit and act as a gateway into smoking.
Finland is not alone in wanting to reduce smoking and all tobacco-related habits among its population. Henning and Rees highlight Australia, where plain packaging on cigarette boxes in combination with taxation has helped bring numbers down rapidly. In 2014-15, just 14.7% of adults 18 or over smoked daily, compared with more than 16% in 2011-12.
On the other end of the spectrum lies China. After a surge in demand for tobacco products in recent years as more people took up smoking, three cities have banned smoking indoors in public places, including the capital, Beijing.
“Tobacco-related deaths are rising because male smoking rates are so high,” Henning said. More than 1.3 million people die each year of tobacco-related disease in China, according to the Tobacco Atlas, linked to the fact that more than 45% of men are smokers. “We’re optimistic that these cities are going to lead the way.”
On a global level, the WHO set a goal to reduce tobacco use among people over the age of 15 by 30% by 2025, to fit in line with goals to reduce rates of non-communicable disease, like cancer, as a result. But Finland remains a pioneer, the first country to set a goal to end the problem in its entirety. Experts, as well as the government, believe they can make it happen.