This rapid assessment survey has been conducted by Pakistan Alliance for Nicotine and Tobacco Harm Reduction (PANTHR), a project of Alternative Research Initiative, on the impact of Covid-19 on combustible smoking and vaping in Pakistan's 11 districts. This rapid perception study assessed availability and accessibility of vaping and smoking during the lockdown and the impact of Covid-19 on them. PANTHR collected primary qualitative data from 120 respondents in 11 districts - Islamabad, Rawalpindi, Lahore, Faisalabad, Sialkot, Multan, Peshawar, Abbottabad, Quetta, Karachi and Hyderabad.
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This study explores the knowledge, attitude, and practices of users of harm reduction products, commonly known as vaping, in 11 city districts of Pakistan. As the first nationwide KAP study of vapers, this research has used self-constructed sampling frame from the existing selling points of vaping in each selected district – Islamabad, Rawalpindi, Sialkot, Lahore, Faisalabad, Multan, Hyderabad, Karachi, Peshawar, Abbottabad, and Quetta. Using the Quick Count Technique.
More than 23.9 million people use tobacco in Pakistan. This makes the country to have one of the largest smoking populations in the world, with grave health consequences, especially for the poor and the marginalized. According to World Health Organization, Pakistan has a heavy burden of disease because of tobacco use.
The use of electronic nicotine delivery systems (ENDS) is a nascent phenomenon in Pakistan and seems to be hiding in plain sight. The people and business operators of harm reduction products (HRPs) are keeping a low key to avoid regulations and/or policies that could affect their business concerns. There are no clear or defined regulations for the use of HRPs including imports, manufacturing or product contents. However, the e-cigarettes and other HRPs are legally imported as consumer goods, with tax duties imposed on them.
Early in 1987 the Conservative government took the radical decision to provide sterile injecting equipment to people who inject in response to the HIV crisis. Only a few months before, it had run an anti-heroin campaign. Now it was giving out free syringes.
I recently addressed the 2020 GTNF conference on the topic of "who is getting tobacco regulation right?". My answer was blunt: at present, very few! If we were, we would not have eight million deaths a year from tobacco use. Nor would we have 1.3 billion people still using tobacco products, most in a toxic combustible or dangerous smokeless form. The goal of a regulator should be primarily to reduce that harm in the fastest possible time. Sadly, this isn't the case today.
The focus of this report is on the contradictions and conflicts experienced by governments that own major stakes in tobacco companies, yet are required to support tobacco control at the same time because they are signatories to the World Health Organization's Framework Convention on Tobacco Control (FCTC). The broader tobacco control environment is not covered by the report, although the context is important.
As a result of the COVID-19 pandemic, it is a challenge for the scientific community to publish results quickly, and publication often occurs at the price of quality and reproducibility, which in turn undermines the public's trust of science.
ENDS are considerably less harmful than cigarettes. Imposing the same tax burden on them (per unit of "harm") as on cigarettes leads to poorer health outcomes. Differential tax treatment of ENDS will encourage more cigarette smokers to switch to ENDS and could save millions of lives worldwide.
Major gaps remain in cessation products' availability and resource allocation for cessation services globally. Current licensed products are falling short on delivering and sustaining smoking cessation. Innovation in cessation products and services needs to build on learnings in nicotine pharmacokinetics, behavioural insights from consumer research and tap into 21st century tools such as mobile based apps. National implementation of FCTC's Article 14 needs to follow guidelines that encourage integration into existing health programmes and health-care practitioners' (HCPs) upskilling.
This study specifically assessed public perceptions of nicotine as opposed to products containing nicotine, which is the focus of previous studies. Apart from showing that consumers often incorrectly perceive nicotine and cigarettes as similar in terms of harmfulness, the authors highlight the need for more accurate and complete reporting by the media to clarify widespread misunderstandings and mitigate public uncertainty.
The purpose of this paper is to illustrate the opportunities for tobacco farmers in Malawi from diversifying to cannabis, and the potential benefits for reducing deforestation by producing a cannabis based alternative fuel. It further argues that there are tensions between the conflicting objectives of the Framework Convention on Tobacco Control and the Single Convention on Narcotic Drugs.
This paper aims to investigate the extent to which three subgroups - people with mental health conditions, people belonging to sexual minority and gender groups and Indigenous peoples - have been "left behind" by countries implementing the World Health Organization's Framework Convention on Tobacco Control
Toxicological testing, population studies, clinical trials and randomized controlled trials demonstrate the potential reductions in exposures for smokers. Many barriers impede the implementation of product substitution in tobacco harm reduction. These products have been subjected to regulatory bans and heavy taxation and are rejected by smokers and society based on misperceptions about nicotine, sensational media headlines and unsubstantiated fears of youth addiction. These barriers will need to be addressed if tobacco harm reduction is to make the maximum impact on the tobacco endemic.
Despite the FCTC detailing the significance of the research, studies are still lacking in the Global South. There are significant research gaps such as longitudinal studies, harm reduction and randomized controlled trials.
For more than thirty years, there have been many calls for the mainstreaming of gender into tobacco control; however, insufficient progress has been made with dire health and economic consequences.
The new generation of tobacco harm reduction products (HRPs) has the potential to save millions of lives and finally end the use of toxic combustible cigarettes.
Smoking-related mortality in 2060 could be cut by about 3.5 million deaths if we: (1) increase access to THR products; and (2) improve treatment, cessation, and diagnostic tools.
Ex-smokers deserve a seat at the table in decisions affecting not only names, but research priorities, regulations, taxes, and bans that affect them.
"Two research studies have highlighted the effective role tobacco harm reduction and cessation strategies can play in achieving the objectives of FCTC and reducing combustible smoking," said Arshad Ali Syed, Project Director of PANTHR. Smoking cessation is completely missing from the tobacco control efforts in Pakistan, he added.
Current available cessation products and services are suboptimal in their effectiveness. Cost and efficacy of current smoking cessation medications on the market is an impediment to availability, accessibility and cessation success in Low-Middle Income Countries (LMICs).
As we evaluate progress toward the goals of the FCTC and how best to update its text, it is vital that we learn from the challenges of other treaties, as well as shortcomings of the FCTC itself. Future efforts must prioritize the end of adult smoking, with particular emphasis on demographics and regions where progress has been slow.
Smokers have never been part of the tobacco control policies in Pakistan. Around 27% smokers in Pakistan at least make one attempt in a year and out of them 2.8% quit smoking successfully.
THC and nicotine vaping involve different devices, liquids, supply chains, people, and purposes. They should not be confused. But they were. Our analysis shows that evaluated news coverage focused primarily on nicotine vaping, and on nicotine itself.
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