POLICIES TO REDUCE TOBACCO HARM IN BULGARIA: LESSONS FROM SMOKE-FREE SWEDEN
POLICIES TO REDUCE TOBACCO HARM IN BULGARIA: LESSONS FROM SMOKE-FREE SWEDEN

Summary/Abstract: Tobacco remains a leading cause of preventable deaths and disability-adjusted life years worldwide. Although the global prevalence of tobacco consumption declines, there are marked differences between EU countries. The percentage of daily smokers in the EU ranged from 6.4% in Sweden to 28.7% in Bulgaria in 2019. Various metrics on smoking habits indicate record high tobacco use in Bulgaria. Unlike this country’s limited success in tobacco harm-reduction public policies, Sweden has implemented well-targeted taxation to differentiate tobacco products by their riskiness, favouring conversion to smokeless tobacco. Bulgaria could draw on the Swedish experience. Whereas policies to reduce smoking in Sweden have been based on the consumption of snus as the most favoured non-combustible tobacco alternative, Bulgaria could support other smoke-free tobacco substitutes gaining popularity in the country. To quantify the potential health gains in Bulgaria assuming a replication of the rates of conversion to smokeless tobacco in Sweden, this study develops an original model where several scenarios are simulated. The results are impressive: Bulgaria could have saved nearly 8 000 lives and reduced up to 222 050 disability-adjusted life years in 2021 if managing to emulate the successful policies of Sweden.

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