Pakistan faces a significant public health challenge due to high smoking rates. Over the past decade, Pakistan has witnessed a very slow decline in smoking rates highlighting the need of adopting effective strategies to reduce smoking prevalence in the country. The economic burden of smoking in Pakistan amounts to Rs 615.07 billion (US$3.85 billion), which accounts for 1.6% of the country’s GDP.
Given the persistent health and economic challenges associated with combustible cigarettes, exploring smokeless tobacco alternatives presents a promising avenue for harm reduction. Smokeless tobacco products, such as snus, chewing tobacco, and nicotine pouches, offer a potentially and comparatively less harmful option for individuals who are unwilling to quit nicotine use altogether. These products reduce the harmful effects of smoking, such as inhaling smoke and tar, while still providing the desired nicotine satisfaction.
Some countries have already adopted smokeless tobacco alternatives as a successful strategy against cigarette smoking. For example, Sweden has the lowest smoking prevalence in Europe, largely due to the widespread use of snus[1]. Snus has been shown to be less harmful than cigarettes and to help smokers quit or reduce their cigarette consumption[2]. Similarly, the US has seen a decline in smoking rates, partly attributed to the increased use of e-cigarettes and other non-combustible tobacco products[3].
Pakistan can learn from these countries and explore the potential of smokeless tobacco alternatives as an effective tool to reduce its large number of smokers. To effectively address the smoking epidemic in Pakistan, policymakers, public health authorities should prioritize exploring and promoting smokeless tobacco alternatives. Implementing evidence-based regulations, awareness campaigns, and programs tailored to these alternatives can help reduce smoking prevalence, improve public health outcomes, and alleviate the health and economic burden caused by tobacco consumption.
[1] https://academic.oup.com/eurpub/article/26/5/817/2197571
[2] https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-022-02662-0
[3] https://www.bmj.com/content/378/bmj-2021-067582
