Pune: On World No Tobacco Day 2022, The Economic Times, India’s leading media, held an interactive thought leadership platform themed ‘Reframing societal view on harm reduction: A medical and scientific perspective’ with the objective of driving discussion and debate around consumer freedom and consumer choices & need for progressive regulations based on scientific methods of harm reduction rather than bans. The multi-stakeholder discussions witnessed participation from renowned subject matter experts across policymakers, science & medicine, legal, think tanks, and consumer organisations.
The first panel deliberated ‘Enabling the shift to less harmful alternatives – Evidence-based policy recommendation’. Speaking on India missing a public health opportunity, with the ban on harm reduction alternatives, David T. Sweanor J.D., Faculty of Law and Centre for Health Law, Policy and Ethics, University of Ottawa, Canada, said, “It is a missed public health opportunity. Substitution is often easier for struggling adult smokers than total cessation. We need to empower them with choices for better health. Banning a low-risk product while protecting the high-risk product is an adverse strategy with more death & disease. Focus on R&D for technology enhancement in providing consumers safer alternatives is pivotal, as have many countries- where access to low-risk alternatives have recorded a rapid decline in smoking.”
Sharifa Ezat Wan Puteh, Professor of Hospital Management and Health Economics, Deputy Dean (Relation & Wealth Creation), Faculty of Medicine, UKM Medical Centre; Malaysia, added, “There is a need to have a strong focus on the benefit to consumers. Policymakers should engage with scientific leaders enabling them to have discussions on the benefits of harm reduction, backed by scientific evidence. Safer alternatives could be a part of the national policy agenda supported by consumer rights & choices for better health. It’s important that knowledge and awareness are propagated across all stakeholders and public at large.”
Sharing his views Dr Kiran Melkote, Orthopaedic Surgeon & member of the Association for Harm Reduction, Education and Research added “There is a need to de-link nicotine and tobacco, as nicotine by itself is not carcinogenic. The endgame of tobacco has become popular again, but so far, globally little has been done to address the problem of tobacco. The pragmatic approach should be to learn from the past and focus on the goal of public health by working towards the goal of saving and making lives better. We can no longer afford to ignore harm reduction”.
The second panel was on ‘Empowering Community Engagement – Creating consumer-friendly regulatory framework’. Despite several measures, India continues to have the second-largest population of tobacco users in the world and has the second-lowest quit rates. Experts deliberated on how the nation appears to be missing a critical tobacco control opportunity and how a scientific policy framework can help the country achieve its goal of eventually being tobacco-free.
Prof Dr. Nimesh G Desai, Senior Consultant in Psychiatry & former Director IHBAS, said, “We need to create more awareness & pragmatism over idealism for tobacco dependence at the policy programme level. Advocating harm reduction v/s abstinence, we need to find levers through which the message spreads widely across policymakers, health professionals, tobacco users and the general public.”
Prof. Bejon Kumar Misra, International Consumer Policy Expert, Honorary Professor -National Law University Odisha mentioned, “Consumers ‘Right to Choose’ must not be denied – safety, education, quality should be the foundation of law making. A Consumer’s best friend is standard and healthy competition – supported by a regulatory framework ensuring the market behaves in an ethical manner and consumers can make informed choices based on credible information.”
Yashaswini Basu, Nyaaya’s outreach lead, Vidhi said, “There is a lot of merit in bringing in an evidence-based approach while formulating harm reduction strategies. Any blanket legislation does not really serve the purpose. If we go to the roster of the courts, every pending litigation related to tobacco and/or smoking is challenging the reversal of the ban.”
In his keynote address, Robert Beaglehole, Professor Emeritus of the University of Auckland and chairs ASH – Action for Smokefree Aotearoa and the Lancet NCD Action Group said, “India is a progressive country and could consider the case of New Zealand in their policy thinking. Over the last two years, the adult daily smoking rate has declined significantly in New Zealand with the use of safer alternatives. We feel close to our goal of smoke-free 2025, with a focus on encouraging adult smokers to quit or transition to less harmful products. As the legislation is taking several measures in creating a smoke-free generation, much like India – promotion, access & availability of safer alternatives is key; while simultaneously addressing the challenge of illicit trade. With the harm reduction tools available, commitment from the policymakers, New Zealand & other countries like India can achieve their tobacco-free vision.”
Samrat Chowdhery, Director, Association of Vapers India (AVI) mentions, “We need to impress upon policy decision-makers about the positive results of harm reduction strategy. Policymakers also need to look at empirical evidence from across the world, where they have witnessed an accelerated reduction in combustible cigarette smoking after the introduction of harm reduction alternatives across age groups. Consumers need to be part of policymaking and need to be part of the discourse; this cannot be a top-down approach as it does not help the larger population.”