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ISLAMABAD: Two non-governmental organizations have started providing innovative solutions for smoking cessation in Pakistan.

According to the experts, Pakistan has witnessed tobacco harm reduction in the form of e-cigarettes users in the last five years and most of them are 18-35 years, who are urbanites, educated, and well-off.

Currently, there are two non-governmental organizations-ARI and PANTHR which are providing innovative solutions in this regard. The PANTHR is focusing on cessation from the perspective of smokers but not backing any particular smoking cessation mechanism. It strongly believes that all their work should be based on research.

While, ARI concentrates on helping smokers make informed decisions on giving up combustible smoking. As an alliance, PANTHR backs all options for backing cessation - whether it is counselling, NRT or vaping.

The organization is backing vaping which is 95 percent safer than combustible smoking and use for harm reduction only for the adult smokers who are unable to give up nicotine.

They said that Pakistan was placed among the top ten raw tobacco producers in the world - ranked 9th in 2016.

Despite being one of the largest tobacco growing countries, however, tobacco is not a major crop in Pakistan. It accounts for only 0.42 percent of the total value of agricultural produce, 0.25 percent the total area under cultivation and only 0.03 percent of agricultural employment.

Cigarette excise taxes in Pakistan account for just over half of the price paid by users. This is below the level in countries that have taken a comprehensive approach to reducing tobacco use, where excise taxes account for 70 percent or more of the retail price.

The experts referred to a study conducted by Oxford Medicine Online* which suggested that Nicotine creates dependence, which keeps people smoking. The smoke contains thousands of toxic agents, many of which are formed in reactions during combustion. If smokers can find satisfactory alternatives to cigarettes that do not involve combustion but do provide nicotine, they would avoid almost all of the disease risk.

A policy that does not consider the voice of key stakeholders is likely to result in a less than successful outcome. Smokers left out in the dark, without guidance regarding cessation options is not going to reduce the number of people hooked to tobacco smoking in Pakistan. Not to mention the tobacco control debate in Pakistan is often quite stagnant, with anyone ever hardly mentioning smoking cessation. This leads to a rather futile debate, where merely increasing taxes is deemed as the Swiss army knife for tobacco control, without considering the motivations of the average smoker and targeting the very mindset which leads to smoking, experts said.

They stated that the smoking cessation is a desirable health outcome and nicotine replacement products are a means of achieving cessation through tobacco harm reduction. E-cigarettes are sophisticated nicotine replacement products. Nicotine replacement therapy (NRT) is a medically approved way to take nicotine by means other than tobacco.

Tobacco use continues to grow in Pakistan due to lack of awareness about its dangers, low prices, aggressive tobacco industry marketing efforts and steady population growth. The daily cigarette consumption is average 13.7 million or annual consumption of cigarette is around 86.7 billion according of Oxford Economics, Asia illicit tobacco Indicator quoted by Sustainable Development Policy Institute (SDPI) report.

Copyright Business Recorder, 2021