Karachi : The Initiative on Risk-reduction & Dependable Alternatives (IRADA) recently hosted its fourth
roundtable discussion in Karachi, reinforcing its mission to advance Tobacco Harm Reduction (THR)
as an essential public health strategy in Pakistan. The event gathered a diverse mix of public health
officials, medical professionals, non-governmental organization (NGO) representatives, media, and
members of the local community, all of whom are pivotal in fostering public understanding and
supporting policies around harm reduction. The primary goal of the session was to enhance
awareness of THR among these stakeholders, promoting science-backed strategies for reducing the
health impacts of smoking by supporting smokers in switching to less risky alternatives.
Dr. Muhammad Rizwan Junaid, a well-known researcher and policy advisor in tobacco harm
reduction, led a detailed discussion on THR’s potential to significantly reduce tobacco-related
diseases and mortality in Pakistan. Dr. Junaid emphasized that adopting THR as a public health
strategy could offer smokers less harmful options, effectively lowering the health burden associated
with traditional tobacco smoking. He cited the success story of Sweden, where THR initiatives have
driven smoking rates to some of the lowest levels in Europe. Sweden’s use of nicotine pouches and
snus, products associated with fewer health risks compared to cigarettes, has been instrumental in
this achievement.
Reflecting on Sweden’s journey toward becoming a smoke-free country, Dr. Junaid remarked, “The
number of lives that could be saved through expanding access to THR is substantial and likely
exceeds almost any other single health intervention governments can implement.” He highlighted
the promising statistics indicating that if THR were to be adopted more broadly, not only in Pakistan
but also in countries like Bangladesh, Kazakhstan, and South Africa, nearly 2.6 million lives could be
saved collectively. This striking data underscores the potential of harm reduction measures to
transform public health outcomes in low- and middle-income countries where tobacco use remains
high.
Throughout the discussion, participants expressed a sense of urgency for Pakistan to adopt
comprehensive THR strategies. In contrast to conventional smoking cessation efforts, THR provides a
science-based approach that reduces the risks of smoking through less risky alternatives. By
prioritizing THR, Pakistan could align itself with global public health efforts to reduce smoking rates
and achieve a future with fewer smoking-related deaths and diseases.
The roundtable also called for concrete actions by the government to support THR. Key
recommendations included developing a regulatory framework that encourages regulation to be
proportionate to the risk they pose to health. Furthermore, they emphasized the importance of
public health campaigns to educate citizens on the health risks of smoking and the benefits of harm
reduction.
Embracing THR could offer Pakistan a realistic path to reducing the country's high smoking rates and
achieving long-term public health goals. The benefits of THR, as outlined by experts at the
roundtable, suggest that Pakistan’s health policymakers have a valuable opportunity to rethink their
approach to tobacco control. By taking bold steps to integrate THR into the national health agenda,
Pakistan could pave the way toward a smoke-free future and protect millions of lives from the
preventable harms of smoking.
