Arbetar du inom hälso- och sjukvård?

Informationen på denna webbplats är avsedd för hälso- och sjukvårdspersonal i Sverige. Är du hälso- och sjukvårdspersonal kan du svara ja för att komma vidare till sidan. Svarar du nej kommer du till vår sida för allmänheten.


Ja Nej

Lämnar Chiesis webbplats...

Chiesi ansvarar inte för information på externa webbplatser.

Vill du fortsätta till extern webbplats?

Ja Nej

Even the tobacco industry acknowledges the harm in smoking and claims to make efforts to transform by reducing health impacts of its products. The solution – as proposed by tobacco companies is not to end nicotine use but switching users to e-cigarettes. The e-cigarette market is growing rapidly but more typically from attracting new users than switching old smokers. Vaping is also where the industry sees its future growth, especially if combined with cannabis. Several of the biggest tobacco companies are investing in the cannabis industry – both medical and recreational use.

Vaping is not harmless. Combustible cigarettes and e-cigarettes, with or without nicotine, increases the resistance of small airways and decreases small airway function1. Sven-Erik Jordt, USA, presented findings from Duke University, that most of the available e-liquid products contain synthetic cooling agents. Addition of menthol is regulated in many markets since its cooling and pleasant sensory effects facilitate smoking and tobacco product initiation. However, since these derivates are without flavor, these may bypass regulatory limits on menthol content in tobacco products as they may not qualify as “characterizing flavor”. This is a potential regulatory loophole that should be considered, especially since health effects of inhaling these compounds are not fully known.

Environmental burden

Beyond the direct health impact cigarettes have on consumers, the lifecycle impacts on the environment are considerable: from deforestation for agriculture of the sensitive tobacco plant that requires heavy use of fertilizers and pesticides, and burning biomass for tobacco curing, to the post-consumer waste with cigarette butts ending up in the oceans, poisoning water.

Greenwashing the industry

To counteract the bad PR and divert attention from the harm done both from manufacturing and consumption of cigarettes, several tobacco companies are establishing an ESG concept (environmental, social and governance for sustainable development) to appear “green” and ethical. They are playing the game to keep investors and succeeding at it. For instance, Philip Morris Industry managed to get a high score on the Dow Jones Sustainability index. The tobacco companies also portray themselves as socially conscious, making charitable contributions, especially in LMIC (low-middle income countries). Labelling tobacco companies as philanthropists: That’s rich coming from an industry that sells a product that kills half of its long-time users, says Elif Dagly (Turkey).

The prevalence of smoking tobacco has unfortunately not been a positive development: The number of smokers globally increased from 0.99 billion in 1990 to 1.14 billion in 2019, most of them coming from LMIC countries. Globally in 2019, smoking tobacco use accounted for 7.69 million deaths and 200 million disability adjusted life years.2

In the final comment on the global burden of tobacco use, Om Prakash Kurmi of the Coventry University, UK concluded that the smoking epidemic is far from over.

The good news, however, is that health benefits come quickly on smoking cessation and life expectancy is increased – it is never too late to stop smoking.

Erika Petersson
Medical Digital Content Manager, Chiesi


  1. Hauck AS, Buchwald I, Watz H, Trinkmann F, Söling C, Ra- benstein A, Ruether T, Mortensen K, Drömann D, Franzen KF. Impact of Chewing Bags, E-Cigarettes, and Combust- ible Cigarettes on Arterial Stiffness and Small Airway Function in Healthy Students. Toxics. 2023 Jan 14;11(1):77. doi: 10.3390/toxics11010077. PMID: 36668804; PMCID: PMC9866725.
  2. GBD 2019 Tobacco Collaborators. Spatial, temporal, and de- mographic patterns in prevalence of smoking tobacco use and attributable disease burden in 204 countries and territories, 1990-2019: a systematic analysis from the Global Burden of Disease Study 2019 [published correction appears in Lancet. 2021 Jun 19;397(10292):2336]. Lancet. 2021;397(10292):2337-2360. doi:10.1016/S0140-6736(21)01169-7.