Harm reduction seen to stem Asia’s smoking epidemic

Leading think tanks asked policy makers in Asia to consider adopting tobacco harm reduction approach and provide access and accurate information on alternative nicotine products such as electronic cigarettes, heated tobacco products and snus.

This was the key message of the 2nd Asia Harm Reduction Forum held today at the Dusit Thani Manila Hotel in Makati City, which gathered leading thinkers from the fields of science, technology, health, policy and consumer advocacy from across Asia and the Pacific. 

Co-organized by the Harm Reduction Alliance of the Philippines and Yayasan Pemerhati Kesehatan Publik Indonesia (YPKP- Indonesian Public Health Observer Foundation), the regional forum builds on the success of the 1st Asia Harm Reduction Forum held in Jakarta, Indonesia last year. 

Participants said that despite strict government regulation, high taxes and extensive public awareness campaigns, smoking remains a major public health issue in Asia, with over half of the world’s smokers living in the region.

The forum aims to educate society on harm reduction through better alternative products and to promote and advocate for practical solutions that can contribute to the improvement of overall public health. 

Its ultimate goal is the integration of harm reduction as a strategy by legislators and the public alike, with the end-goal of ensuring improved health and a healthy environment. 

Rep. Anthony Bravo of Coop-NATTCO Party-list, a leading advocate of tobacco harm reduction in the Philippines, delivered the keynote speech during the forum. 

Panelists from Indonesia, Singapore, Philippines, India and Sweden focused on identifying ways to regulate alternative products in support of tobacco harm reduction in the forum’s morning session. “Many Asian countries remain very skeptical about tobacco harm reduction, and some have even banned alternative nicotine products. Regulators need to see that tobacco harm reduction is potentially the most effective solution to solving the smoking epidemic in Asia, and can complement existing tobacco control measures,” said Harap lead convenor Prof. Ron Christian Sison.

Apart from the point of view of policy makers, AHRF 2018 also presented the latest scientific developments in tobacco harm reduction from leading health practitioners and academics. 

It noted that there is a growing body of evidence supporting the public health benefits of tobacco harm reduction, particularly the development of less harmful nicotine delivery systems. 

Public Health England of the United Kingdom and the Food and Drug Administration of the United States are among the authorities that have adopted tobacco harm reduction in formulating their tobacco control policies.

The forum featured a powerhouse line-up of international speakers. 

Prof. Tikki Pangestu of Singapore discussed evidence-informed public health policies for harm reduction while Dr. Marewa Glover shared the New Zealand Approach to Tobacco Harm Reduction.

Dr. Hiroya Kumamaru talked about alternative tobacco products in Japan and their positive impact to accelerating the decline in the country’s smoking rate while Dr. Kgosi Letlape shared the tobacco harm reduction experience in South Africa from which Asian countries may learn.  Prof. Helen Redmond of the New York University – Silver School of Social Work, discussed vaping and vulnerable populations. 

Sison said that as Asia today has the highest number of smokers in the world, the public health benefit from tobacco harm reduction in the region would be immense. “The Asia Harm Reduction Forum provides a venue for scientists, health practitioners, academicians, policy observers, as well as consumers to exchange ideas on how best to advance tobacco harm reduction in Asia. We believe that this Forum will greatly benefit the public health sector and particularly smokers in Asia who deserve improved access to alternative tobacco products,” he said.

“The ‘quit or die’ approach in Indonesia does not work for some smokers. Therefore, it is time to consider the ‘quit or try’ approach; that is, try alternative nicotine products,” said YPKP co-founder Dr. drg. Amaliya. She said that smoking prevalence is declining at record speed in countries such as the UK and Japan where alternative nicotine products are widely available. 

Amaliya said that thanks to innovation and technology development, alternative nicotine products are now available to provide a satisfying and less harmful option for smokers to get their nicotine fix without the harmful tar. “We need to actively inform policymakers about tobacco harm reduction and the potential benefit of alternative nicotine products to public health,” she said.

More than half of the world’s smokers are in Asia. 

In 2005, 49 percent of men and 14 percent of women in Japan smoked. In 10 years, the country’s smoking rate has decreased to 18.2 percent of the total population, according to the 2018 State of Smoking Survey. 

The global survey revealed that the decline in Japan’s smoking rate has accelerated in recent years with the entry of heated tobacco products in the market. 

The 2015 Global Adult Tobacco Survey showed that almost 1 in 4 (23.8 percent) Filipino adults were smokers. 

The smoking rate among Filipino women (5.8 percent) is among the highest in Asean. On average, smokers in the region start smoking before the age of 20. The average age of smoking initiation among Filipino daily smokers is 17.8 years. Indonesia currently has the world’s highest smoking rate of 76.2 percent among males aged 15 and above.

According to the UK Tobacco Control Plan, around 3.2 million people in the UK are currently using e-cigarettes, with an estimated 40 poercent of them using e-cigarettes as a stop smoking tool and tens of thousands successfully quitting smoking each year as a result.