For the first time, a Tobacco Harm Reduction Summit was held in Dhaka on Saturday to discuss a new strategy towards achieving the Prime Minister’s vision of a 'smoke-free Bangladesh’ by 2040.
It publicised the effective role tobacco harm reduction (THR), as distinct from other strategies aimed at eradication, can play in fighting the scourge of smoking. THR can be implemented side-by-side with traditional strategies.
Notable international public health experts, policymakers and media personnel gathered at the summit organized by Asia Harm Reduction Alliance and discussed the need to regulate less harmful alternatives of nicotine delivery in a risk-proportionate manner, alongside stricter restrictions on traditional cigarettes.
THR is a public health strategy to reduce or minimise the health risks to individuals and wider society associated with conventional tobacco products. It amplifies the value of smoking cessation, but where smokers are unwilling or unable to quit, they can switch to innovative smoke-free technologies that deliver nicotine without the harmful bits - i.e. the smoke or tar.
These are also referred to as Reduced Risk Products or RRPs, and include vaping devices, oral nicotine pouches, heated tobacco products and other non-combustible alternatives of nicotine delivery. Currently, the U.K., Sweden, New Zealand, Canada and many other progressive nations of the world are encouraging the use of such products to reduce smoking incidence by regulating them through a risk-proportionate regulatory framework.
Moderated by Dr. Delon Human, the event featured globally renowned public health experts like Dr. Derek Yach, Prof. Mihaela Raescu, Dr. Kgosi Letlape, Dr. Marewa Glover, Dr. Konstantinos Farsalinos, Michael Landl, Masud-Uz-Zaman, Federico Fernandez with representation in the audience from ministries of industries, finance, commerce, home affairs, and other institutions such as Bangladesh Investment Development Authority (BIDA).
Dr. Derek Yach, former WHO Cabinet Director and the person who co-led the development of the Framework Convention on Tobacco Control (FCTC) said: “Harm reduction strategies have always been part of the FCTC and tobacco control, but thus far not fully implemented. Bangladesh has the opportunity to translate its economic transformation into accelerating tobacco control through harm reduction. It will save lives."
Dr. Delon Human, a former secretary general of World Medical Association and an adviser on global public health strategies to three Directors-General of the WHO and to UN Secretary-General Ban Ki Moon, expressed his concerns at the event: “The fundamental principle of public health is to prevent and control disease and premature death. With traditional tobacco control, there is little to no hope to achieve the aim of a smoke free world by 2040. Frankly, this is a death sentence for the almost 1.4 billion current smokers in the world, which include 20 million kind citizens of Bangladesh. How can this message of doom be turned into one of hope? By fully integrating harm reduction policies, science and regulated products into tobacco control.”
Dr. Marewa Glover, a New Zealand public health academic specialising in smoking cessation opined, “The poor and indigenous people in most countries suffer disproportionately from high smoking rates and tobacco-related disease. All stakeholders need to work together to improve access to smoking cessation services, including smoke-free nicotine alternatives, as has been done in New Zealand, through vaping products."
Dr. Konstantinos Farsalinos, a Greek cardiologist and the most cited THR researcher in the world suggested, “The evidence is clear, smoke free nicotine alternatives such as vaping products are at least 95% less harmful than cigarettes and the preferred method of quitting for most smokers. Along with oral nicotine pouches, these are gateway products out of smoking and should be made available in Bangladesh within well monitored, risk-proportionate regulatory frameworks.”
Former president of the World Medical Association and founder of Africa Medical Association, Dr. Kgosi Letlape emphasised on ensuring access to harm reduction tools as basic human rights and highlighted the role of health professionals in contributing to the goal.