Tobacco dependence services in Sweden and Swedish Nurses Against Tobacco

37-monaMona Wahlgren
Swedish Nurses Against Tobacco
37-flag Sweden
23 Aug 2013



The Swedish Public authorities at all levels are guided by 11 public health objective domains decided upon in 2002,  one of which was tobacco. The goal for the year 2014 is to reduce tobacco use overall with the specific aims of:

  1. tobacco free life start
  2. decreasing the number of youths starting smoking and using snuff to half
  3. decreasing  the number smokers by half
  4. a smoke free  environment for all citizens

Sweden has also been part of Framework Convention on Tobacco Control (FCTC) since 2008.

The National Board of Health and Welfare published in 2011 guidelines for methods of primary disease prevention by supporting patients in their efforts to change unhealthy lifestyle behaviors. These lifestyle behaviors are: a) tobacco use, B) hazardous use of alcohol, 3) insufficient physical activity and 4) unhealthy eating habits. The basis for all methods is assigned to three levels – brief advice, counseling and advanced counseling. The healthcare system should offer advanced counseling to smokers visiting for example primary health care centers. More sporadic smoking cessation is also included for pregnant and breastfeeding women and for persons scheduled for surgery. This group is subject to special recommendations. Health care professionals should have training in the methods they use as advanced counseling

Quit-Smoking- Line

The Swedish quit smoking line – Sluta Röka Linjen (SRL) started in 1998. It is a nationwide free-of-charge telephone service financed by the Ministry for Health and Social Affairs. The quit-smoking-line operates five days a week. Educational written materials, tailored to the individual smoker/snus users are available, free of charge. Those who stop smoking are offered four follow-up phone calls (proactive service) and are encouraged to call back as often as they need (reactive service). The quit-smoking- line is promoted as a referral service for the primary health care and hospital clinics. Health professionals can also call the line for guidance in tobacco cessation.

The smoking cessation treatment services are usually organized in primary health care and provided by a registered nurse (RN). Most hospitals offer surgery patients a smoking cessation program before their operation. There are some hospitals with smoking cessation clinics for any smoking patients.


Education and training to qualify for smoking cessation counselor is a two stage process.  The first stage is a 2-3 day course in smoking cessation including facts about tobacco, treatment and practical exercises. The second stage includes three coaching sessions in groups. The delegates present case studies of patients in smoking treatment verbally and in writing. After the final one day course including examination the delegates get their certification as smoking cessation counselors. The Course is certified by Health Professionals against Tobacco including different health professions; nurses-, doctors-, psychologist-, dental care- and teachers.

Swedish nurses against tobacco (SNAT)

SNAT is a nongovernmental organization (NGO) funded by the Swedish National Institute for Public Health and membership is open for all RNs. The goal is to raise awareness on the importance of tobacco prevention in all nurse specialist organizations. The board is represented by nurses from hospital, primary health care, school health and midwives. SNAT organizes a network of nurses covering all 20 county councils in Sweden. All members are invited yearly to a one-day seminar. SNAT offers also every other year a one-week smoking cessation program for members in the National Association of Health Professionals.

Important issues for 2013 are:

  • Implementation of the National Guidelines for methods of Disease Preventing  in collaboration with other  nurses specialist organizations
  • Certification of courses for delegates to become qualified tobacco cessation counselor.
  • Courses in motivational interviewing
  • Lobbying for “Tobacco Endgame” a complete cessation of smoking in Sweden by the year 2025

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