Clearing the Smoke : Assessing the science base for Harm Reduction

The recent ET Consumer Freedom Conclave provided us with various distinct views at the panel discussion, where experts discussed harm reduction avenues and methods aimed at protecting people's health and reducing social ills in communities.

The third edition of The Economic Times Consumer Freedom Enclave focused on the scientific methods of harm reduction covering policies and practices seeking to protect health and reduce social harms of people and communities. Risky health behaviors run rampant. In order to better understand how those suffering from substance abuse can be empowered, enabled, and encouraged industry leaders from the medical and scientific community were invited for a panel discussion to discuss and debate how safer substitutes and less harmful alternatives need to be provided and its impact in providing choices to individuals and communities.

The panel discussion saw representation from Prof. Dr. Sharifa Ezat Wan Puteh, Community Health Specialist, Faculty of Medicine, The National University of Malaysia (UKM), Dr. Kiran Melkote, Orthopedic surgeon and member of Association for Harm Reduction, Education and Research, Dr. Lorenzo Mata Jr, President, Quit for Good and Supratim Chakraborty, Partner, Khaitan & Co.

Harm reduction is an alternative strategy for the smoker who cannot or will not quit and broadly refers to the policies, programs and best practices that help minimize the negative societal impact of substance abuse. Harm reduction originally referred to smoking and has encompassed a broader range of products, including tobacco, which is a very important area.

Malaysia has a belt of hardcore smokers which not only leads to a large cost, but also to an increased death rate due to heart and non-communicable diseases. For some countries, tobacco harm reduction is still a taboo, however addressing this issue requires governance. Prof Puteh shared that UK has one of the best policies to have condoned the area of harm reduction. Substance laws and strategy are geared towards preventing the use of addictions and providing those who are addicted (including alcohol) with comprehensive range of treatments.

It is time to look at these issues with a broader lens, instead of blaming a lack of political will. As soon as these alternate products start becoming popular without being regulated, regulators begin to focus on them. According to Supratim, the larger manufacturers of these products lobby hard to see there is a ban on the newer alternatives, which is not the solution.

Different regulations by countries pose a challenge. The elements that the governments must keep in mind while framing policies include economic, societal and the administrative regulation. While the social regulation is playing a large role, the way forward would be to have a balanced approach for all three.

Dr Mata quotes that about 80% of the smokers want to quit but the behavioural transition and nicotine addiction make it difficult. Only 1 of 10 smokers has managed to quit with over 30 attempts on an average. The lesser harmful alternates assist in their journey from smoking to quitting.

Choice plays a large role – said Dr Melkote. WHO and most governments have chosen the not-so-viable cessation-only approach? The misinformation campaigns continue to run amok. Harm Reduction needs to be acknowledged as the viable strategy for tobacco to move forward. Despite the growing scientific research, tobacco harm reduction products are not always viewed as life-saving interventions with misconceptions surrounding the category. Most smokers are addicted to nicotine, which if delinked and provided with products like nicotine patches, will surely make a difference.

Governments must be open with their approach without being influenced by industries. Lately, many sectors have been subjected to blanket bans which seem to be heavy on ideology, but light on research. Research can help understand what the plausible solutions are. Bans don’t really work. It just disappears from the public view but is always a thriving underground economy where it becomes even more draconian, with no regulation and harming the youth further. Clearly there are some trade-offs. Consumer rights and policies must become more grounded in scientific findings and more evidence-based. Policymakers who evaluate harm reduction strategies based on investment versus outcomes need to realize the end goal. Both smokers and medical experts must be educated on the science behind the less harmful nature of the smoke-free alternatives and clinical trials should be augmented. Cold-turkey is the pillar of advocacy, which is not feasible.

India has 267 million tobacco users, and the government’s goal is to reduce tobacco usage by 30% by 2030. Our society has built its products on the laziness of consumers, where more harmful products are more readily available with safer alternatives difficult to access. The availability, affordability, accessibility, and acceptance of alternatives would certainly cause a significant shift in health. Poorly designed products and low-cost supplements will be chosen by consumers if there is no proper way to deliver them.

For “Clearing The Smoke”, the private and public sectors need to work in tandem and make part of this vision a reality, which may take years, but it is necessary. Academicians and doctors can play a vital role in promoting this thought with the society at large.

Disclaimer: The views expressed in this article are those of the author and do not necessarily reflect the views of ET Edge Insights, its management, or its members

Leave a Comment

Your email address will not be published. Required fields are marked *

Scroll to Top