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ISLAMABAD: The cigarette use costing a whopping US$3.85 billion to 15 million smokers in the medical bill in Pakistan, can be saved, if the government extends an efficient cessation service including Nicotine Replacement Therapy (NRT) in government healthcare facilities aided by Harm Reduced Products (HRPs).

This has been stated by the Quality Belligerence, an Islamabad-based policy advocacy Organization, here on Thursday, during an interaction with the media.

Many imported HRPs after paying 20 percent customs duty have made inroads in Pakistani markets capturing all high-, middle- and low-income groups.

The Pakistan Ministry of National Health Services, Regulations and Coordination (NHSRC) should end its ambivalent policy on innovative tobacco products to clearly articulate, if these can be used as cessation aid as has been done by many developed countries on the basis of clinical trials.

In the scientific evidence-based decision making, Sweden, Japan, New Zealand, the UK and many others have started adopting HRPs as cessation aid.

The UK's National Health Service (NHS) has unequivocally adopted HRPs as an essential component of quit smoking, saying that many thousands of people in the UK have already stopped smoking with the help of an e-cigarette. This is because there is growing evidence that they can be effective. There is no tax on e-cigarettes in the UK.

A clinical trial from a large New Zealand vaping population, funded by the Health Research Council in 2019, suggested that hundreds of thousands of more smokers worldwide could successfully quit the killer habit, if they used nicotine-containing e-cigarettes (vapes) together with nicotine patches.

The WHO, however, differentiates between NRT and HRPs calling latter novel and emerging tobacco and nicotine products including Heated Tobacco Products (HTPs), Electronic Nicotine Delivery Systems (ENDS), Electronic Non-Nicotine Delivery Systems (ENNDS) and other products.

The WHO report on the tobacco epidemic states that tobacco cessation support worldwide remains low, with less than 30 percent of the world having access to appropriate tobacco cessation services even though 70 percent of all people who smoke want to quit.

For Pakistan, where 22.2 percent men and 2.1 percent women are smokers (GATS), means that there is a need to provide cessation facilities to 15.6 million people to prevent 160,000 tobacco-related illnesses deaths annually.

In Pakistan, except for "Offering help to quit tobacco use", the government is implementing all other parts of the MPOWER strategy with mixed results.

Being party to WHO's Framework Convention on Tobacco Control (FCTC), the NHSRC has reported to the FCTC secretariat in 2,000 on the status of FCTC's implementation that tobacco dependence and counselling services for the cessation of tobacco use are virtually nonexistent. The NHSRC also conveyed to WHO that it does not have any statistics on the HRPs.

The WHO has started monitoring of HRPs saying that monitoring the use of ENDS among both adults and adolescents is important for understanding the level of use and the trends.

Countries began collecting data on the current use of ENDS in 2013, and 42 countries now have nationally representative data available. However, the indicator is not yet collected in enough countries to permit an estimate of the global level of use.

Derek Yach, president of Foundation for a Smoke-Free World, said: "There is growing evidence that a range of harm-reduction products, including e-cigarettes (vapes), snus, nicotine pouches, and heated tobacco products, can help smokers quit or at least substantially reduce their harmful exposure to combustible cigarettes. The WHO, supported by heavily funded Bloomberg Philanthropies grantees, continues to blindly ignore scientific evidence, vilifying these products instead of promoting their use to save lives. The WHO, supported by heavily funded Bloomberg Philanthropies grantees, continues to blindly ignore scientific evidence, vilifying these products instead of promoting their use to save lives."

Copyright Business Recorder, 2021

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