PANTHR opposes call for ban on tobacco harm reduction products

Islamabad : The Pakistan Alliance for Nicotine and Tobacco Harm Reduction (PANTHR) Saturday opposed a call to ban tobacco harm reduction products in low and middle income countries (LMICs), and advocated accessible and affordable smoking cessation services in 22 Eastern Mediterranean Region (EMR) countries to help smokers quit smoking.

“On this World No Tobacco Day, it is obvious smoking cessation is a missing and weak link in the tobacco control efforts in EMR,” said Kashif Farooqi, PANTHR’s coordinator.

The International Union against Tuberculosis and Lung Disease has called for prohibiting the sale of e-cigarettes and heated tobacco products in LMICs, which are home to more than 80% of the world’s smokers. “On the contrary, smokers in LMICs need support to quit smoking. We believe a complete implementation of Article 14 of the FCTC is needed to reduce the burden of tobacco use in LMICs, and especially in EMR,” it said.

Under Article 14 of the FCTC, member states are to take effective measures to promote cessation of tobacco use and adequate treatment for tobacco dependence. Smoking cessation support is missing in Pakistan, Egypt, Oman and Djibouti—the four countries in which half of the EMR population lives. “It is time we make smokers part of the smoking cessation strategies.”

Kashif added that there is a need for national consultation on how to make smoking cessation an essential part of tobacco control efforts in Pakistan and EMR. “UK and Japan have successfully used alternate products to decrease the prevalence of smoking. In March 2020, Public Health England advised smokers to switch to e-cigarettes to help them quit smoking, but at the same time asked non-smokers not to take up vaping. This advice comes after six annual independent reports commissioned by PHE on vaping in England.”

Kashif said Pakistan, which is the most populated country in EMR, is not implementing measures on tobacco cessation support and supplementary information. He added, Pakistan currently lacks a national tobacco cessation strategy and cessation clinical guidelines. “The country does not include tobacco in at least one national disease specific treatment guideline, and tobacco use status of patients is not routinely recorded on medical grounds.”

As national toll-free quit line is not included on health warnings or mass media campaigns, training in tobacco cessation is not part of the medical degree or training in Pakistan, Kashif added. Sudan is only other country in EMR not implementing these measures.

Overall tobacco use among males in EMR countries is high. The World Health Organization (WHO has predicted a smoking rate (tobacco prevalence) of 18.6% in EMR in 2020. Though WHO expects a decrease in tobacco prevalence from 20.5% in 2015 to 17% in 2025 in EMR, the number of tobacco users will increase to 94 million in 2025 from 90 million in 2015 because of population increase. Half of the male population aged 15 and above in Tunisia and Lebanon uses tobacco, followed by 42.3% in Egypt, 41.6% in Bahrain, 41.2% each in Kuwait and Iraq, 36.1% in UAE and 34.6% in Pakistan.

Additionally, WHO expects smallest decrease in tobacco smoking rates in EMR. The overall tobacco smoking prevalence is projected to drop from 18.3% in 2010 to 16.3% in 2025, if current tobacco control efforts continue in EMR countries.

Kashif said that there is need for more collaboration and research on ending smoking in EMR countries. “Ensuring accessible and affordable smoking cessation services in EMR countries is a challenge that has not been addressed adequately. This aspect should be addressed on urgent basis,” he concluded.