Background:
Sweden has one of the lowest smoking rates among developed countries but according to The Tobacco Control Scale 2016 Sweden shares a disappointing 9th place among European countries in implementing tobacco control. Earlier studies of smoking cessation activities have been few and inconsistent. By an NGO initiative in 2005, a comprehensive national training standard for tobacco cessation was established. Since then 930 individuals have completed the training and have been certified.

Methods:
In 2016 an anonymous e-mail survey was sent to the 21 certified training centres and forwarded to cessation specialists certified from 2005. Twenty per cent of the addresses were no longer in use leaving 740 possible responders.

Results:
A total of 542 valid responses were received, or 73%. Responders were 97% female and 3% male. Most (80%) were active in cessation. A majority, or 58.7% worked 0.5-2 hrs./week with smokers, 23,7% spent 2.5 - >20 hrs./w and 17.7% were inactive. No one reported demand for snus cessation. Almost all (90%) counselled patients individually. Three out of four responders were nurses or midwifes, working in primary care. Fifteen per cent worked in hospitals. The support for smoking cessation in their organisation was judged as “good/very good” by 43%, “neither good nor bad” by 44% and “bad” by 5%. It was calculated that on average, a cessation expert treats 22 patients/year.

Conclusions:
This is the first national report on the clinical experiences of the large number of smoking cessation counsellors 1-12 years after their certification. The results show a high response rate and 4 out of 5 responders are clinically active in smoking cessation. The results are encouraging and much more convincing than earlier studies. Still, better standardisation and continuous monitoring could further improve the service.