Debunking – “Tale of Two Nations Vol 9: A Comparative Study of how Sri Lanka and Sweden are Faring in the Fight Against Smoking”

Summary

• “Tale of Two Nations Vol 9 – A comparative study of how Sri Lanka and Sweden are faring in the fight against smoking” is a report published by the “Smoke free Sweden”, a campaign directly linked to tobacco industry.
• The report promotes the tobacco industry’s harm reduction approach, undermining effective global and local tobacco control efforts.
• The report contains multiple inaccurate and misinterpreted facts, which is a strategy akin to the tobacco industry tactics of lying, telling half-truths, and generating doubt about established scientific consensus.

Background

“Tale of Two Nations Vol 9: A comparative study of how Sri Lanka and Sweden are faring in the fight against smoking” (please see image 01) is a report published by “Smoke Free Sweden” on 08 of November 2025 on their website. “Smoke Free Sweden” is a campaign launched by the “Health Diplomats” in March 2023, which as an organisation with direct links to British American Tobacco (BAT). Ceylon Tobacco Company PLC (CTC), the tobacco company holding monopoly of cigarette manufacturing and sales in Sri Lanka, is a subsidiary of British American Tobacco (BAT), with BAT holding 84% of its shares.

Image 01: Cover page of the report

This report was authored by Delon Human and Noel Somasundaram.

Delon Human is a South African medical doctor and is the founder of “Health Diplomats”. He has collaborated with British American Tobacco (BAT) in their “tobacco harm reduction” activities. Read more about him on the Tobacco Tactics page.

Noel Somasundaram is a Sri Lankan Specialist Endocrinologist who formally worked at the National Hospital of Sri Lanka, Colombo. He has co-authored several publications which promotes tobacco industry’s harm reduction approach, some of which are directly funded by British American Tobacco (BAT) and Philip Morris International. Read more about him on the TU page Noel Somasundaram.

“Smoke Free Sweden” has published 11 such reports under the theme of “Tale of Two Nations” comparing Sri Lanka, Kenya, Pakistan, France, Spain, Mexico, Uzbekistan, and Argentina to Sweden and comparing South Africa, Bangladesh, and Zambia to New Zealand. Delon Human is mentioned as the sole author of six of these reports, while in four he has collaborated with a local author. The report on South Africa vs New Zealand does not mention an author.

Publishing of the Report

A local advertising agency named The Sri GAGs published two posts (Image 02) on their Facebook page in December 2025, and March 2026, quoting this report promoting the tobacco industry’s harm reduction approach. Read more on the TU page The Sri GAGs – TSG Advertising.

Image 02: Facebook post referring to the Tale of Two Nations report published on The Sri GAGs

In addition, “Business News”, an online business news portal in Sri Lanka has published an article titled “Sri Lanka’s restrictive policies on safer nicotine ‘will cost 85,000 lives’” on 12 February 2026 quoting this report.

The CCT team could not find any other publications in local media about the report.

Tactics used in the Report

The investigation conducted by the CCT team on the report revealed multiple factual inaccuracies, selective use of evidence, and misrepresentation of public health data. The investigation also highlighted the adoption of well documented tobacco industry tactics aimed at sustaining nicotine addiction and weakening evidence-based tobacco control policies, which are elaborated in the sections below.

Misinformation

Attributing Sweden’s Decline in Smoking to Snus and Nicotine Products

The report repeatedly claims that low smoking prevalence in Sweden is due to widespread use of snus and other nicotine products. Multiple research publications clearly highlight strong tobacco control policies and legislations, such as smoke free environments, comprehensive bans on tobacco advertisements, promotions and sponsorships, implementing recommendations of the WHO Framework Convention on Tobacco Control (FCTC), had played key roles in achieving a low smoking prevalence in Sweden.

The report mentions that vaping was introduced to Sweden in 2015 and nicotine pouches in 2016, and the daily smoking prevalence among males, which was over 50% in 1960s, came down to around 11% by 2015.This indicates that the larger decline in smoking was achieved prior to the introduction of e-cigarettes or other nicotine products through the strict regulations Sweden adopted. The authors have opted not to include this observation, which contradicts the industry narrative. Read more about this on the Tobacco Tactics page.

Misleading Information about Sri Lanka

In the image no 03, the smoking prevalence among Sri Lankan men is depicted in a way that it is rising despite multiple studies have demonstrated that smoking prevalence in Sri Lanka is decreasing among both men and women.

Image 03: An excerpt of the misleading infographics from the report.

Another graph used in the report (as shown in image no 04) mentions that daily adult smoking prevalence in Sri Lanka remains the same from 2015 to 2023 at 10%. Contrastingly, daily adult smoking prevalence in Sri Lanka has decreased from 10.2% in 2015 to 6.4% in 2020.

Image 04: A second excerpt of the misleading infographics from the report.

Misquoting Information

• Several statements in the report are not supported by the cited original source, which is inaccurately paraphrased. Examples of such statements, alongside the corresponding facts from the referenced original source, are presented in table 01.

Table 01: Summary of statements in the reports

Misquoted statement as Presented in the Report	Source Cited	Accurate Information from the Source
“… no regulated nicotine-containing products available in the market. This means consumers seeking safer alternatives to combustible cigarettes face a stark choice: continue smoking or turn to a completely illicit market for nicotine alternatives.”	A newspaper article published in Daily FT on 24 January 2025 titled “Alcohol, tobacco and cannabis nexus and substance abuse challenge wellbeing of Lankans” The article reports on a press conference conducted by tobacco control advocates in Sri Lanka, including CCT, Sri Lanka Medical Association, National Authority on Tobacco and Alcohol, ADIC Sri Lanka, College of Community Physicians, College of Psychiatrists, and the Young Professionals Alliance for Health, focusing on the public health harms of alcohol, tobacco, and cannabis.	The cited Daily FT newspaper article highlights statements made by the stakeholders that attended the press conference, but does not support the statement mentioned in the Tale of Two Nations report. The cited newspaper article mentions the adverse effects of oral tobacco products, including oral cancers and related diseases, which is not reflected in the ‘Tale of Two Nations’ report.
“After nicotine pouches were introduced in 2016, quit rates accelerated further, particularly among women who had previously found other alternatives unappealing. By ensuring all these options are accessible, affordable and socially acceptable, Sweden has successfully reduced its smoking rate by 54% since 2012. Official data reinforces this success. Among Swedish-born individuals over 16, only 4.5% smoke”	Public Health Agency of Sweden	The website clearly mentions that daily cigarette smoking has decreased in Sweden since the 1980s and this decrease coincides with the broad tobacco prevention efforts that have been carried out since 1960s. These efforts included reducing tobacco availability, decreasing social acceptance of smoking, expanding access to cessation programmes, and implementing long-term, collaborative measures such as advertising bans, effective taxation, age restrictions, and smoke-free environments. It also highlights the fact that snus users have a higher tendency to start smoking than people who do not use snus.

Disregarding Scientific Evidence that Challenges Harm Reduction Claims

The tobacco industry’s harm reduction approach, such as promoting use of snus and other nicotine products, has not been found to be effective in reducing the prevalence of or harm from smoking. A large number of independent studies confirm this. The results of a few of such studies are mentioned in the table 02 below.

Table 02: Summary of select studies revealing the ineffectiveness of the tobacco industry’s harm reduction approach

Title	Authors	Published Year	Main Findings
Use of New Tobacco and Nicotine Products as a Harm Reduction Strategy: A Critical Review of the Evidence	Carlos Andrés Jimenez-Ruiz et al	2026	“[N]none of these forms [electronic cigarettes, heated tobacco products, nicotine pouches] are effective in helping smokers to quit and their use should never be recommended in smoking cessation programs”
European Respiratory Society statement on novel nicotine and tobacco products, their role in tobacco control and “harm reduction”	Daniel Tzu-Hsuan Chen, Jonathan Grigg, Filippos T. Filippidis	2024	“The ERS Tobacco Control Committee draws the conclusion that we still lack sufficient independent evidence to support the tobacco industry's so-called “harm reduction” claims. All these nicotine products remain highly addictive and harmful”
Prospective study of e-cigarette use and respiratory symptoms in adolescents and young adults	Alayna P Tackett et al	2024	“E-cigarette use in young adults was associated with respiratory symptoms, independent of combustible cannabis and cigarette exposures”
A systematic review of cancer risk among users of smokeless tobacco (Swedish snus) exclusively, compared with no use of tobacco	Håkon Valen et al	2023	“Some of the studies retrieved in this systematic review, reported an increased risk of cancer of the esophagus, pancreas, stomach and rectum as well as cancer-specific death associated with the use of Swedish snus.”
Factors associated with predictors of smoking cessation from a Norwegian internet-based smoking cessation intervention study	Inger T Gram et al	2022	“… current snus use was a predictor for unsuccessful [smoking] cessation for both sexes. Our results indicate that smokers should be warned that snus use may prevent successful smoking cessation.”
Co-optation of harm reduction by Big Tobacco	Timothy Dewhirst	2020	“ … the goal of harm reduction is not achieved if the commercial marketing communication of next-generation products serves to attract new users such as youth that are never smokers, encourages dual use (in combination with combustible cigarettes in accordance with the use setting) or discourages cessation”

The Tale of Two Nations report has failed to acknowledge such studies, reflecting a clear bias towards and a strong support for the tobacco industry’s harm reduction approach, particularly the promotion of snus by the tobacco industry.

Denial of Tobacco Industry Motives to Sustain Nicotine Addiction

This report attempts to highlight that the Tobacco Industry’s motive is to find solutions for Tobacco epidemic. However, scientific research has demonstrated that the Tobacco Industry’s main intention is to continue making profits by sustaining nicotine addiction. Scientific evidence reveal that tobacco companies have invested in, developed and promoted newer nicotine and tobacco products in order to prevent current smokers from quitting and to attract new users. Ultimately, the aim is to offset the diminishing profits from conventional tobacco products, use of which is on the decline. However, the main driver of growth for tobacco companies is still cigarettes; and this is likely to continue to be the case for the foreseeable future.

Misleading Cross-Country Comparisons

The comparisons drawn between Sri Lanka and Sweden in this report overlook fundamental demographic, historical, and regulatory differences. Sweden implemented comprehensive tobacco control policies and legislation as early as the 1960s, resulting in a substantial decline in smoking prevalence over subsequent decades. In contrast, Sri Lanka’s national tobacco control framework, the National Authority on Tobacco and Alcohol (NATA) Act No. 27 of 2006, was enacted much later, with key tobacco control measures emerging primarily from the 1990s onwards.

Downgrading Global Public Health Strategies

Statements such as “[a] tobacco ‘generational endgame’ policy is mooted to prevent future generations from ever using tobacco products. However, unless there are regulated safer, smoke-free alternatives as an ‘off-ramp’ this could further entrench the illicit market” in the report suggest that global tobacco control efforts will worsen the illicit market, another narrative commonly used by the tobacco industry. This framing overlooks extensive evidence demonstrating the success of comprehensive tobacco control strategies. Thus, the report exhibits a biased perspective that downplays the proven impact of conventional tobacco control interventions.

Concerns Regarding References

Quoting Publications Funded by the Industry

This report has quoted another publication by the same authors titled “Lives Saved Report: Saving 85,000 lives in Sri Lanka, the impact of complementing”, which is based on multiple tobacco industry funded studies. This “Lives Saved Report” claims e-cigarettes are 95% less harmful compared to combustible tobacco products. The details of few of such studies are mentioned in the Table 03 below.

Table 03: Summary of studies claiming e-cigarettes are less harmful

Title	Authors	Published Year	Funding or conflict of interest
Estimating the Harms of Nicotine-Containing Products Using the MCDA Approach	David J. Nutt et al	2014	Euroswiss Health, an organisation established by Pierre-Yves Mayor and Delon Human.
A tale of flawed e-cigarette research undetected by defective peer review process	Riccardo Polosa and Konstantinos Farsalinos	2022	Riccardo Polosa has received grants from Foundation for a Smoke Free World, an organization funded by Philip Morris International.
The health impact of smokeless tobacco products: a systematic review	C Hajat et al	2021	Authors have received grants and sponsorships from ECLAT, Health Diplomats, ECITA (Electronic Cigarette Industry Trade Association, in the UK), Foundation for a Smoke Free World; organisations with directs links to tobacco companies.

Research done by Charlotta Pisinger et al in 2018 analysing 94 studies revealed that studies influenced by the tobacco industry were more likely to present tobacco- and e-cigarette industry-favourable results, such as that e-cigarettes are harmless. However, almost all papers without a conflict of interest involving the tobacco industry found potentially harmful effects of e-cigarettes.

Self-citation

This report frequently relies on self-citation, repeatedly citing the authors’ own publications as in-text references. This raises questions about the comprehensiveness of the literature review and reflect a bias in the selection of supporting evidence.

Duplicating references in the list

The reference list contains duplicated citations, with Reference no. 03 and no. 16 being identical, as well as Reference no. 02 and no. 07. Such repetition indicates lapses in editorial actions and may affect the perceived reliability and accuracy of the report.

Non-adherence to scientific referencing guidelines

The report does not follow any recognised scientific referencing method. Key details such as publication dates, URLs, or access dates are missing (please see image 05). Some references appear as hyperlinks, but some of them are not functional, which limits verification and undermines the credibility and reproducibility of the report.

Image 5: An excerpt from the report.

Statements not backed by references

Although the report mentions statements like,

• “Sweden has formally adopted tobacco harm reduction as a national policy, shifting its focus from “reducing consumption” to actively “reducing harm”. This commitment has positioned the country as a global leader in public health innovation”
• “Nicotine pouches, vapes and snus offer safer alternatives”

they are not supported by proper scientific references.

Implications

Authors of this Tale of Two Nations report have employed a wide range of tactics to promote tobacco industry narrative of the tobacco harm reduction approach to promote nicotine products in Sri Lanka. However, according to the Regulations on Prohibited Tobacco Products in Sri Lanka under National Authority on Tobacco and Alcohol (NATA) Act No 27 of 2006, electronic cigarettes containing tobacco (aka vapes), smokeless tobacco products (including snus), and flavoured, coloured, sweetened tobacco products are scheduled as prohibited tobacco products in Sri Lanka. Accordingly, no person shall manufacture, import, sell or offer for sale any prohibited tobacco product

This Tale of Two Nationa report is an example of the tobacco industry’s attempts to manipulate science and, also an example of the tobacco industry trying to claim a public health advocacy role. Both these examples highlight well documented prominent tactics used by the tobacco industry. Read more about these tobacco industry tactics related to harm reduction on Tobacco tactics.

TobaccoUnmasked resources

• Ceylon Tobacco Company PLC (CTC)
• British American Tobacco (BAT)
• Noel Somasundaram
• The Sri GAGs – TSG Advertising
• Framework Convention on Tobacco Control (FCTC)
• National Authority on Tobacco and Alcohol (NATA) Act
• Regulations on Prohibited Tobacco Products in Sri Lanka

External resources

• The Swedish Experience
• Delon Human
• Tobacco Industry Tactics

The local language translations