Tobacco harm reduction merits place as human rights issue

Islamabad : Tobacco Harm Reduction (THR), which sits at the intersection of public health and human rights, merits its place as a human rights issue. THR policies should be regarded as complementary rather than inimical to reducing the global death and disease burden from smoking. Effective exit routes out of smoking should be made available to smokers who want to avoid smoking, and access to Safer Nicotine Products (SNPs) should be ensured to encourage them to switch away from cigarettes— one of the most dangerous ways of consuming nicotine.

This is one of the key messages enshrined in the ‘Global State of Tobacco Harm Reduction 2020’ report released on Wednesday. Titled ‘Burning Issues,’ the report focuses on THR and the benefits of having access to affordable, appropriate and acceptable safer alternatives to combustible tobacco products. It also focuses on the rights of smokers, who need the opportunity to switch from smoking and those who have chosen safer alternatives.

The report’s central theme is the universal right to health, including for those who—for whatever reason—continue to engage in risky behaviours. “Harm reduction does not focus on eradication of products or behaviours. The humane response is to reduce the risks, thereby enabling people to survive and live better—in this case through access to SNPs,” the report states. According to the report, the global prevalence of SNPs stands at 98m, of whom 68m are vapers. There are only nine users of SNP for every 100 smokers.

The estimated total number of smokers globally—at 1.1 billion—is static, the same number as in 2000, and predicted to be the same in 2025, disproportionally affecting poor and marginalised groups, especially in low and middle income countries (LMICs). “The WHO has not revised downwards, its estimate that 1 billion lives could be lost to smoking-related disease by the end of the century. This is equivalent to the combined populations of Indonesia, Brazil, Nigeria, Bangladesh and the Philippines dying from COVID-19. The highest reported levels of smoking mostly occur mainly in LMICs, which consequently shoulder the heaviest burden of disease and mortality. There are 22 countries where 30 percent or more of the overall adult population are current smokers,’” the report informs.

While commending some countries that have taken a more inclusive approach to THR as part of the overall strategy towards a smoke-free world, the report emphasizes that traditional tobacco control interventions elaborated in the Framework Convention on Tobacco Control are not enough. “WHO continues to express concern that the unabated levels of smoking will undermine attainment of the SDGs and ensure that the 2030 targets to reduce levels of non-communicable disease will be missed,” it states in a bid to underline the importance of seizing THR as a global opportunity for one of the most dramatic public health innovations ever to tackle a non-communicable disease and at minimal cost to governments.