LETTERS: Low-to-Middle-Income Countries (LMIC) lack of acceptance and availability of alternative non-combustible nicotine products were among the major topics discussed at the Global Forum on Nicotine (GFN) 2021 on June 17 and 18.
In line with the event's theme "The Future for Nicotine", discussions revolved around updates that several developed countries saw a drop in smoking rates following an increase in public awareness on the dangers of smoking and availability of non-combustible nicotine alternatives.
LMIC, on the other hand, remained a large and vulnerable market for traditional tobacco products.
People smoke to obtain nicotine, a comparatively low-risk substance, but are harmed by the thousands of toxins released when tobacco ingredients, such as tar, burn.
With the Tobacco Harm Reduction (THR) approach, adult smokers who cannot quit are encouraged to switch to safer nicotine products such as vapes (e-cigarettes), pasteurised snus, non-tobacco nicotine patches and heated tobacco devices.
Up to 98 million consumers worldwide have already made the switch to safer nicotine products.
In England, health authorities support vaping to quit smoking and vapes are now the most popular tobacco quit aid.
Tobacco-related mortality in Sweden, where snus has almost replaced smoking, is the lowest in Europe, and in Japan, cigarette sales have dropped by a third since heated tobacco products came to the market.
"Manufacturers must ensure safer alternatives are affordable to people in LMIC, not just consumers in high income nations," said GFN director Professor Gerry Stinson.
He urged the World Health Organisation to refocus efforts on supporting 1.1 billion adult smokers to quit by all available means and promote the THR strategy.
Health psychologist and tobacco addiction expert Sairah Salim-Sartoni highlighted that alternative nicotine products act as exit strategies forsmokers who intend to quit.
"The more products you create, the more exits there are for smokers. Here is where you start to achieve the goal of ending the smoking endemic," she said on the second day of the forum, held in Liverpool, the United Kingdom.
Alternative products, she said, needed to be sold side-by-side with traditional cigarettes as this gives smokers the ability to purchase the products just as easily as the latter.
Meanwhile, Foundation for a Smoke-Free World president Dr Derek Yach stated that from a scientific perspective, the hard work was completed but what remained was the difficult cultural and political work.
There are now two distinct silos in tobacco research: one in which the evidence for harm reduction is robust and growing; and one in which such evidence does not exist, he said.
According to the Health Ministry's National Health and Morbidity Survey 2019, the prevalence of smokers in Malaysia stood at 21.3 per cent, equivalent to 4.9 million people, and more than 27,200 deaths annually in the country are related to smoking.
Addiction Medicine Association of Malaysia president Dr Steven Chow revealed that 50 per cent of smokers in Malaysia were keen to quit and it was their duty as doctors to help them achieve it.
He said ideologies must be set aside to prioritise progress towards the common goal, which is to end the habit of smoking.
Tasnim Lokman
Kuantan, Pahang
The views expressed in this article are the author's own and do not necessarily reflect those of the New Straits Times