Global calls to switch to smoke-free tobacco products gaining ground

LAHORE - Amidst growing realization worldwide regarding the hazardous effects of combustible tobacco products consumption, the calls for switching to safer alternates to ensure tobacco harm reduction are gaining momentum.

Recently, the advocates of smoke-free tobacco products from different Asian countries gathered for the first time ever in Jakarta, Indonesia, to call on their governments to allow and regulate the use of electronic cigarettes and ‘heat-not-burn’ tobacco products, which are considered far lesser harmful alternates to smoking. The event is regarded as a major headway towards smoke-free products.

The estimates of the World Health Organisation (WHO) suggest that almost half of the world’s 1.1 billion smokers live in Asia, with Indonesia and India having among the biggest populations of smokers, globally. Thousands die each day in these countries due to complications related to smoking such as heart diseases and cancer.

The world health body also notes that in the year 2015 alone, over 1.1 billion people smoked combustible tobacco products that “would kill up to half of its users.” Estimates also measure the death toll caused by smoking at 7 million people across the globe, annually. Slowly and gradually, combustible tobacco products have become one of the biggest public health challenges to ever surface on the world map.

In this alarming scenario, several countries throughout the world are switching to smoke-free products to minimise the potential health risks.

In recent years, England has pioneered scientific research and government policies on tobacco harm reduction to achieve a faster decline in smoking rates than most other countries. Keeping in mind its responsibility to share more information about ways to quit smoking, Public Health England recently initiated the ‘Stoptober’ campaign to encourage smokers to switch to vaping. The UK government is eyeing to reduce smoking to 12 per cent of adults not later than the end of 2022 and it seeks a ‘smoke-free generation’ to reduce smoking to 5 per cent or less in the adult population in the long-run, says Frontier Economics in its central forecast ‘for a smoke-free England by 2040.’

The document cites relevant data and estimations of the British government to suggest that smoking could be reduced to 5 per cent as soon as 2029. “This would require the more rapid decline in smoking in England since 2012, which coincided with the increased popularity of e-cigarettes, to be sustained,” it says. The report also highlights the projected positive impact of e-cigarettes in the proposed creation of ‘smoke-free England.’

“Greater use of e-cigarettes and novel smoke-free products could assist in delivering a smoke-free England earlier. To achieve smoke-free target earlier, there is a need to reverse the decline in smokers switching to e-cigarettes.”

UK’s Royal College of Physicians Tobacco Advisory Group said in a research report issued last year that “large-scale substitution of e-cigarettes or other non-tobacco nicotine products, for tobacco smoking has the potential to prevent almost all the harm from smoking in the society.”

According to another research report on heat-not-burn products from the Committee of Toxicology (COT), an official body that gives independent scientific advice to the UK government, the heat-not-burn products are 50 to 90 percent safer in comparison with conventional cigarettes.

Britain is not the only country to have taken the related measures for promoting smoke-free products. Generally, European countries have shown a remarkable improvement in reducing hazardous effects of smoking with the active implementation of European Union Tobacco Products Directive introduced in 2014. This directive clearly distinguishes e-cigarettes and heated tobacco products from combustible tobacco.

Noted harm reduction advocate David T Sweanor says smoke-free tobacco products have given Sweden the lowest smoking rate in Europe. The products that heat tobacco rather than burning have helped Japan to achieve the world’s fastest decline in cigarette use. In addition, the smoke-free products are legally available and gaining rapid popularity in Korea and the United States. The US Food and Drug Administration (FDA) has announced this year that its anti-tobacco regulation would be fully geared towards harm reduction, while New Zealand’s Ministry of Health has also recently endorsed the use of electronic cigarettes.

Still, switching to the safer alternatives to smoking is regarded as a challenge in some Asian countries, including Pakistan, due to low public awareness and lack of legislation to distinguish between combustible tobacco products and heat-not-burn products. These smoke-free products can complement the traditional tobacco control policies as a new product category that encourages smokers to switch to less harmful alternatives to cigarettes, in turn providing a major benefit to public health

In a country like Pakistan where smoking poses serious challenges, England’s experience can serve as role model in the introduction and implementation of harm reduction measures by switching to practicable alternates. According to some estimates, 100,000 people in Pakistan die of smoking annually (274 daily) and over 5,000 people are hospitalized every day due to tobacco-related diseases. Experts suggest that switching to non-combustible alternatives is a better option than continuing to smoke. In view of the successful experience of UK, authorities in Pakistan should review regulation of non-combustible products as a priority to drive down smoking rates and cigarette consumption.

With proper legislation, effective oversight and regulatory measures to differentiate and categorise smoke-free products separately from combustible tobacco products, Pakistan can also join the global revolution for a smoke-free future and tobacco harm reduction.

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