The government has undertaken concentrated efforts to encourage a safer lifestyle for adult smokers and lower smoking rates.
However, population growth considerably outnumbers adult smokers quitting. Given that the government’s efforts over the last two decades have had no influence, tobacco has become an inextricably linked part of our culture. What could the government do to keep smokers of legal smoking age?
Experts have, however, pointed to a solution for the smoking epidemic. Dr. Bharat Gopal, Director of Pulmonology, at Delhi Heart and Lung Institute (DHLI) clarified, “Tobacco use is the leading cause of cancer – and it is avoidable. There is no safe way to use tobacco, a major risk of cancer comes from the combustion of tobacco or tobacco smoke. Most toxic substances including carcinogenic agents are released due to combustion. If we can somehow remove combustion from the process, it would lead to reduced harm for legal-age smokers who find it difficult to quit.”
Countries all across the world are dealing with this scourge, but some have found a happy medium in the shape of safer alternatives for adult smokers who are unable to quit. Safer alternatives have been a scientifically proven concept across products that primarily harm the body.
In the early 2000s, the WHO Framework Convention on Tobacco Control (FCTC) evolved through a four-year-long consultative process that included all stakeholders. The most important lesson from the conversations was that tobacco regulations could not be a ‘one size fits all’ answer. Furthermore, the FCTC conference of parties urges nations to regulate tobacco control measures through harm reduction tactics that are consistent with national laws and public health goals.
Sharing his views on how tobacco causes harm and what role risk management could play, Dr. Kiran Melkote, an Orthopedic Surgeon based in Delhi, and Director of AHRER (Association for Harm Reduction, Education and Research), said, “The concept of risk management can only be successful if we understand what is causing the harm. Nicotine
does not cause harm; it is present in multiple day-to-day products that we use today. Other carcinogenic agents released on combustion cause the majority of harm to legal-age smokers. Hence better alternatives that remove combustion from the process could be safer than combustible cigarettes and need to be regulated to save lives in the country.”
Countries like Japan and Sweden are prime case studies that show the impact of adopting a reduced-risk and scientifically backed tobacco control policy. Japan witnessed a drastic fall in hospitalizations for COPD, COPD exacerbations, and ischemic heart disease (IHD) after the introduction of safer alternatives in the country. Sweden has seen a fall in national smoking rates from 15% to a mere 5.6% in the last 15 years, taking the country close to the ‘smoke-free’ tag.
India’s healthcare policy innovations are examples of policymakers pivoting on prescribed programs to suit the larger population’s interest. The Pulse Polio Immunization Program by the government helped India go from having 60% polio cases in the world in 1994 to becoming a polio-free country in 2014. Similarly, the digital health platform developed in India to fight covid-19 resulted in a successful immunization program in the country. The government should take a leaf from these examples, combined with global case studies, and explore the impact of safer alternatives that could save 100 million lives.
