Despite losing 8 million people to smoking every year from around the world, the worldwide prevalence of smoking is more or less the same. In 2016, it was estimated that over 23.9 million adults in Pakistan were indulging in the habit of smoking while in 2018 the mortality rate attributable to cigarette smoking stood at around 160,100 in the country. Being a member of the WHO Framework Convention on Tobacco Control since 2005, Pakistan has repeatedly initiated campaigns that stress on diminishing smoking, in line with the strategies proposed by the WHO. In addition to this, a separate entity, the Tobacco Control Cell, has also been established that works to strengthen and ensure tobacco control efforts in Pakistan. In light of Pakistan’s continued struggle with the plague of cigarette harm, it is crucial to take a rigorous approach against smoking and promote a smoke-free environment.
While the most effective approach is to quit smoking altogether, studies and common observations have shown that it is quite difficult to halt smoking habits all of a sudden due to the strong addictive nature of nicotine. In most cases, the sudden smoking cessation and the resultant nicotine withdrawal can cause a person to relapse.
In this situation, switching to smokeless alternatives can aid in reducing the harm inflicted by traditional cigarettes and can even help smokers slowly move towards quitting completely. One such line of products are heated-tobacco products (HTP) that heat up the tobacco to such a temperature that it does not actually burn, but only produces nicotine-aerosol.
Recently the United States Food and Drug Administration (FDA), authorized the marketing of such products based on scientific evidence that the alternative product significantly reduces the production of harmful and potentially harmful chemicals. The FDA has also shown the positive likelihood of these products in helping smokers cut down on their tobacco intake, which can eventually help them in smoking cessation through harm reduction. According to a detailed evidence-based report published by National Institute for Health and Care Excellence (NICE) in 2013, consumption of licensed nicotine products is presented as a recommended harm-reduction approach that can also help in cessation without relapse risks.
In addition to reduced harm to the smoker through these alternatives, there is also a consensus that these products carry less risks of harm caused by secondhand smoke. According to the WHO, around 1.2 million people are killed every year by inhaling intoxicated smoke produced by traditional cigarettes. A study by the Agency for Healthcare Research and Quality shows that the aerosol produced by smokeless alternatives contain relatively reduced toxins than the smoke produced by traditional combustible cigarettes which contains a mix of 7000 deadly chemicals, thus, reducing the threat of passive smoking.
These alternatives can also play a pivotal role in reducing the negative impact on the environment. A study conducted by Tobacco Control Unit of Italy’s National Cancer Institute suggests that cigarette smoke produces 10 times more air pollution than a diesel car’s smoke. Ammonia, carbon dioxide, and cyanide contained in traditional cigarette smoke are some of the leading causes of air pollution, while the non-biodegradable nature of cigarette butts pollutes our land and water. Alternatives to conventional cigarettes can counter all these environmental threats and can help in attaining a smoke-free environment.
However, the need is for the government and tobacco control authorities to take immediate notice of the harm inflicted by cigarettes, and adopt a flexible anti-smoking strategy that works on a systematic approach to smoking cessation through the introduction of reduced risk products.