WHO: One Billion People Will Continue To Smoke By 2025. Here's What You Need To Know
To tackle this issue, we must be well-informed on all the available options to reduce smoking prevalence globally.
By Shiffa Aziz — 13 Jul 2023, 09:30 AM
Did you know there are an estimated 4.8 million Malaysians who currently smoke?
Based on the National Health and Morbidity Survey 2019, this accounts for 21.3% of Malaysians aged 15 years and above.
Meanwhile, on a global scale, the World Health Organisation (WHO) projects that a billion people will continue to smoke by 2025.
In light of these worrying numbers, governments around the world have been taking various measures to tackle this persisting issue. From smoking cessation programmes to awareness campaigns, these efforts are carried out to help smokers kick the habit once and for all.
With all these ongoing developments, the concept of tobacco harm reduction is becoming an option for countries looking to reduce the prevalence of smoking
Harm reduction, first introduced in the 1980s for public health and substance use, is an approach that minimises the negative effects of a certain set of practices or behaviours. It recognises that not everyone will be able to put a stop to these deeply ingrained behaviours, hence it focuses on reducing the associated risks and harms instead.
Tobacco harm reduction involves the use of less harmful products, consisting of e-cigarettes, nicotine replacement therapy (NRT) products, and heated tobacco products.
When taking a closer look at reduced-risk products, the argument presented here is that combustion does not occur, hence the number of harmful chemicals produced is greatly lessened
For example, heated tobacco products are just as the name indicates — the tobacco in these devices is heated, not burned. According to the Centers for Disease Control and Prevention (CDC) in the US, the emissions from heated tobacco products contain generally lower levels of harmful ingredients compared to smoke from conventional cigarettes.
Countries such as New Zealand recognise the potential of vape to encourage the transition of adult smokers to smoke-free alternatives, and aims to contribute to the nation's Smokefree 2025 goal.
In a 2022 UK research report that summarises the evidence on vaping products, it finds that e-cigarettes are at least 95% less harmful than smoking
The report, originally commissioned by Public Health England (PHE) and now the Office for Health Improvement and Disparities (OHID) in the Department of Health and Social Care, stands behind the belief that vaping poses only a small fraction of the risks of smoking.
The UK has embraced the tobacco harm reduction approach as early as 2007, where the use of safer forms of nicotine instead of smoking was endorsed by the Royal College of Physicians. In fact, there is a growing number of countries that are recognising the benefits of alternatives to smoking, such as the USA, Greece, New Zealand, and Uruguay.
However, it is worth noting that reduced-risk products are not an alternative to smoking cessation. While not risk-free, these products are intended for smokers who would continue to smoke.
Tobacco companies such as Philip Morris International (PMI) for instance, are changing their approach to cigarettes by researching and developing smoke-free alternatives
PMI has employed over 1,500 scientists, engineers, technicians, and support staff globally while investing 10.7 billion dollars into research and development at the Cube, PMI's research and development centre. It aims to deliver a smoke-free future by 2025 with its array of heated tobacco products, oral smokeless, and e-vapour products.
In the midst of transforming their business, the company believes that smokers should first and foremost be encouraged to quit. However, for adult smokers who would otherwise continue smoking, former PMI CEO André Calantzopoulos said, "Our ambition is to convince all current adult smokers that intend to continue smoking to switch to smoke-free products as soon as possible."
In an interview with SAYS, Professor Dr Sharifa Ezat Wan Puteh, Ex-Deputy Dean at UKM Medical Centre's Faculty of Medicine and current president of the Malaysian Harm Reduction Society (MSHR), shared that the first objective of reduced-risk products is to reduce harm among smokers
She adds that this is possible by switching from combustible tobacco to reduced-risk, non-combustible products.
"If you are a smoker, and you are comfortable switching to products such as NRT, go ahead. As for people who are recalcitrant, they may need additional help from reduced-risk products," she said.
However, Dr Sharifa acknowledges the importance of proper regulation and taxation for reduced-risk products, especially for e-vapour.
"I do agree that they (reduced risk products) need to be taxed, because this can be used to help healthcare in return, but it has to be done properly, in the sense that we need to guide people on how to use them.
"Labelling is another issue, in which I find some products are not being labelled properly. There are too many (e-juice) flavours at the moment. I know that flavouring is needed because we need to entice smokers to switch and keep them from conventional cigarettes, but sometimes having too diverse packaging that appears colourful encourages youngsters to vape. So that has to be sort of controlled in a way."
When it comes to staying informed about tobacco harm reduction, Dr Sharifa's advice is to carefully scrutinise any studies or reports to prevent misinformation from occurring
"By right, the information [about tobacco harm reduction] should not only be informative, but should also be disseminated in a responsible manner. The low-income and disadvantaged groups are at the highest risk of tobacco in Malaysia. So, we want to keep them safe by converting them to something that is safer.
"There are already cessation products like NRT which are already available over the counter. The question is, are they effective? If people are able to convert from conventional cigarettes to reduced smoking, and eventually abstinence with NRT, this is good.
"But when we are talking about people who do not have access, do not have enough money to purchase NRT, or do not have enough information on how to quit through NRT, then they should be counselled on how to use other alternative methods, which has worked in other countries," she said.
