The Shift Pakistan Needs: Tobacco Harm Reduction as a Solution

Pakistan is currently facing a significant smoking problem, with 31 million smokers and over 160,000 deaths each year due to smoking-related issues. Despite decades of stringent tobacco control policies, smoking rates remain disturbingly high, showing that traditional approaches have not been successful. For smokers who do not want to quit, tobacco harm reduction (THR) presents a practical and effective solution. This approach, which is being adopted by many countries worldwide, allows smokers to reduce health risks.

Around 144 million people globally have already transitioned to better alternatives, indicating a shift in how countries regulate these products and address smoking-related harm. Proper regulation is crucial to ensure smoke-free products are effective, clearly labeled, and marketed responsibly. It also helps raise awareness and prevents smokers from turning to unregulated or harmful products. In the U.S., for instance, the Food and Drug Administration (FDA) recently authorized the marketing of Zyn nicotine pouches, a smoke-free, tobacco-free product, acknowledging it as a better option compared to smoking.

Sadly, Pakistan has not yet embraced this approach. Anti-tobacco organizations (ATOs) are making it even more challenging for smoke-free products to be viewed as part of a harm reduction strategy. These groups host seminars, advocacy campaigns, and discussions to invite government officials and bring them on board to influence policy decisions that oppose THR alternatives. Although products like Zyn nicotine pouches, heated tobacco products (HTPs), and vapes are available in Pakistan, ATOs continue to push for restrictive measures, preventing policymakers from supporting harm reduction strategies. They overlook the scientific evidence that while nicotine is addictive, it is the combustion process – not nicotine – that causes the majority of harm. By eliminating combustion, smokers can greatly reduce their exposure to dangerous substances like tar and carbon monoxide.

Therefore, a scientifically-informed approach in Pakistan could provide effective solutions to the smoking crisis.