An alternate to better public health

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  • April 23, 2021
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Global public health is under dual pressure: while the ongoing pandemic is putting public health under pressure, another high-burden epidemic – the tobacco epidemic – has been unnerving public health for decades, pushing more than 8 million people from around the world to the verge of death every year. In a scenario where an average smoker is smoking about 14 cigarettes a day, when smoking even one cigarette a day can lead to higher risks of heart diseases and stroke, the state of public health is pretty much telling. The best response in this situation is, without a doubt, for an adult smoker to quit. However, this is not always easy. This raises the need for an additional public health strategy complementary to existing efforts to control smoking incidence; with a significant segment of the population in Pakistan that continues to choose to smoke, there is a need for less harmful alternatives to conventional cigarettes, or reduced risk products, to be available to consumers. The adoption of a tobacco harm reduction strategy, at the population level, lies at the intersection of the availability of scientifically-proven reduced risk products and the framework that allows for adult smokers to switch to these products in the interest of overall better public health. For this, the foremost need is to study the scientific data that can advise on reduced risk products and their ability to act as a supplement to public health strategies.

One such evidence is the peer-reviewed research, titled Heat-not-burn tobacco products: a systematic literature review, that analysed over 31 independent studies to evaluate the efficiency of heat-not-burn (HNB) tobacco products and their impact on human health. The results highlighted that HNB products delivered lower peak concentration and total exposure to nicotine as compared to cigarettes, while also weakening the urge of smokers to smoke as frequently. The study also asserted that due to the smoke-free nature of HNB products, it also exposed bystanders to substantially fewer harmful compounds than cigarettes, in addition to reducing harm for the user.

To further understand this phenomenon and to identify what components of smoking inflict harm on human body, it is important to understand the impact of a burning cigarette. The burning of tobacco in a cigarette produces over 6,000 chemicals, about 100 of these chemicals have been found to be harmful or potentially harmful to a smoker’s health. On the other hand, heat-not-burn products have completely eliminated combustion from the process, instead heating tobacco to produce an aerosol that contains 95 per cent lower levels of toxicants as compared to cigarette smoke, according to a study by the Public Health England (PHE).

In light of the extensive scientific researches, the potential role of such options for the betterment of public health, and testaments from global public health entities including FDA and PHE regarding reduced risk, these products are now available across 61 cities in the world as a smoke-less alternate for adult smokers. In Japan and England, smoking incidence rates have seen a sharp decline following the launch of HNB products in their markets, substantiating the effectiveness of these products on public health.

The UK Committee of Toxicology further testifies this relation and says “[I]t is likely that there is a reduction in risk, though not to zero, to health for smokers who switch completely to heat-not-burn tobacco products.” This acknowledges that urging smokers to quit their habit completely all of a sudden might not be achievable by all, thus a more sustainable and impactful option would be if they are asked to modify their behaviour and shift to less harmful products, reducing the range of chemicals their bodies are exposed to.

This alternate approach to public health can therefore lead to a wider impact on health since while it caters to the individual needs of an adult smoker, it simultaneously responds to the wider public health as well.

Courtesy :  The Nation

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