Tobacco Harm Reduction: Paving the Path Forward for Pakistan

In the ongoing battle against smoking, Pakistan grapples with the widespread impact of this deadly habit. With a population of approximately 242.8 million and an estimated 27 million adult smokers, the country faces significant challenges in tackling smoking-related health issues. Despite efforts to curb its use, Pakistan’s fragile healthcare system continues to bear the burden of treating smoking-related illnesses.

While some may argue for a blanket ban, such a measure is unlikely to succeed in a country like Pakistan due to the thriving black market, which would only exacerbate the problem. This highlights one of the primary challenges in smoking control in Pakistan — the prevalence of illicit trade, with non-tax paid tobacco now capturing 63% market share due to the ineffectiveness of the track and trace system, and the lack of political will. Illicit trade not only undermines efforts to reduce smoking prevalence but also poses significant risks to public health and results in revenue loss for the government.

For a country facing multifaceted challenges, turning to science for tobacco harm reduction (THR) emerges as the most pragmatic step forward. Harm reduction encourages adult smokers, who are addicted to nicotine and unwilling to quit, to transition to less harmful alternatives.

According to Dr. S Abbas Raza, a Consultant Endocrinologist at Shaukat Khanum Hospital and Research, who co-authored a recently published international research report titled “Integrating harm reduction into tobacco control”, incorporating THR into Pakistan’s tobacco control framework holds the potential to save over 1.2 million lives.

Dr Raza suggests that Pakistan can follow the lead of progressive nations by promoting THR as a viable alternative to conventional smoking. “Pakistan has the opportunity to emulate these achievements by prioritizing harm reduction initiatives and empowering adult consumers with alternatives proven to be less harmful,” he said.

The success stories of European countries, particularly Sweden, serve as compelling evidence of the efficacy of harm reduction strategies. The Scandinavian country’s broad endorsement of snus and nicotine pouches, driven by its science-based health policy, has contributed significantly to the decline in smoking rates.  However, India’s ban on THR products at the end of 2019 served as a cautionary tale. The prohibition led consumers to illicit markets, exposing them to greater health risks. Pakistan must learn from this and avoid making similar mistakes.

While Pakistan moves forward in the fight against smoking, embracing harm reduction is crucial. By incorporating THR into its tobacco control framework, Pakistan cannot only save lives but also empower individuals to take control of their health and alleviate the burden on the healthcare system. Adopting innovation and evidence-based strategies to combat smoking addiction will pave the way for a smoke-free future.

This article is written by Huzefa Muhammad. He is a freelance writer with a keen interest in Science and Technology.

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