Mapping of harm reduction products in Pakistan

Introduction

This scoping study reviews the status of HRPs in Pakistan for their use as harm reduction and smoking cessation tools. The study has been divided into two parts – literature review and consultation with stakeholders, including the tobacco control advocates. A total of 21 interviews were held with the stakeholders in Islamabad and Karachi. Compared to huge body of research work on combustible smoking,
the preliminary assessment found lack of research literature on HRPs in Pakistan. The research and nonresearch material, mainly in the form of new stories, and the consultation with the stakeholders, have been synthesized on the HRPs use in Pakistan. Though there are no exact figures available about the number of HRP users in Pakistan, their number is negligible compared to cigarette smokers. The HRP users were identified and interviewed in Karachi and
Islamabad. The report provides a contrast between the heavy tobacco use, including combustible smoking, and the emerging use of HRPs in Pakistan. It also highlights the stances and understanding of the tobacco control community on the use of HRPs as a smoking cessation tool. It analyses the factors of acceptance, availability and prices of HRPs. It also reviews the socio-economic backgrounds of the cigarette smokers and the HRP users. Based on the findings, the report identifies possible opportunities for future work on HRPs in Pakistan.

Limitations

As this is a qualitative study based on the literature review and interviews with the HRP users, the findings are broad-based which need to be probed further. E-cigarette vendors were generally reluctant to talk about the use of e-cigarettes as they feared their businesses’ legality was being questioned. As the use of ENDS is a new phenomenon in Pakistan, exact
figures are not available. HRP users were also reluctant to talk about their use of e-cigarettes.
Some of the tobacco control advocates questioned the role of Foundation for Smoke-Free World (FSFW). WHO representative refused to meet and discuss HRPs in Pakistan. He maintained that WHO does not
collaborate with any research backed by the tobacco industry.

HARM REDUCTION IN PAKISTAN – A STATUS REPORT

The research on HRPs in Pakistan remains patchy with three studies undertaken in the last two years. The geographic reach of these studies was limited to one city in the province of Sindh. The focus of the studies is assessing awareness, perception and use of e-cigarettes. No medical research with regards to e-cigarette or HRPs has been carried out in Pakistan.

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