A fresh strategy for combating smoking.

According to WHO data, tobacco products were responsible for 100 million deaths in the 20th century alone. Each year, 8 million people die from smoking-related diseases. 80% of these deaths occur in low- and middle-income countries, and if current trends continue, another billion people may die from tobacco-related diseases in the 21st century.

One of the authors of the report is Dr. Delon Human, President and CEO of Health Diplomats, a consultant to the World Health Organization and the UN on global health issues. He noted that while complete cessation of smoking remains a desirable goal, for many individuals who cannot or do not wish to quit smoking, a tobacco harm reduction strategy offers a less harmful alternative. This includes switching to so-called smokeless nicotine products, such as e-cigarettes, vapes, and heated tobacco products. These products do not produce tobacco smoke, thereby reducing health risks such as lung cancer and other smoking-related diseases.

According to Dr. Human, the implementation of this strategy as part of health policy in countries aiming to improve public health will bring significant benefits to society and the state, including reduced levels of disability, premature mortality, and healthcare costs associated with smoking-related diseases.

Countries like Sweden, the United Kingdom, and New Zealand have already demonstrated that the introduction of smokeless nicotine alternatives helps a significant number of smokers transition to lower-risk products, reducing disease and mortality rates. In Sweden, for instance, due to the widespread use of snus and nicotine pouches, the smoking rate has dropped to 4.5%, officially making the country "smoke-free." Japan has also shown successful results, where cigarette sales significantly decreased from 2011 to 2023, and over half of smokers switched to heated tobacco products.

The report on saved lives asserts that implementing a tobacco harm reduction strategy in Uzbekistan, along with improved access to effective nicotine replacement therapies and lung cancer treatments, could save 464,000 lives in the country by 2060. Out of these, THR accounts for 304,000 saved lives. This data was obtained using a model that predicts lives saved by applying existing measures and integrating harm reduction methods into the tobacco control system.

Dr. Human also pointed out that WHO forecasts do not take into account improvements in lung cancer treatment and effective smoking cessation methods, which can significantly affect the final outcomes. He stated that lung cancer is one of the leading causes of death from smoking-related diseases, and advancements in diagnosis and treatment can greatly enhance survival rates.

In response to the bans on nicotine pouches and the proposed ban on e-cigarettes and heated tobacco products in Uzbekistan, Dr. Human noted that such measures are inconsistent. He emphasized the importance of preventing the use of tobacco and nicotine products among youth; however, he believes that banning less harmful alternatives for adult smokers is ineffective and leads to an increase in illegal trade. Countries such as the USA, the UK, and Sweden have already implemented strategies that allow adult smokers to switch to safer alternatives.

Regarding nasvay, a popular tobacco product in Uzbekistan, Dr. Human stated that it cannot be considered part of a harm reduction strategy. Nasvay has a toxicological profile that does not meet the standards for smokeless nicotine products. WHO warns about the risks associated with nasvay use, including oral cancer and other serious diseases, and supports strict regulation of these products.

Dr. Human also expressed support for initiatives aimed at exploring the benefits of tobacco harm reduction, including the proposal to establish a WHO working group to assess these approaches. He is confident that creating such a group could significantly reduce health risks associated with smoking and help improve public health worldwide.

In conclusion, Dr. Human highlighted three key areas for Uzbekistan that could significantly improve the situation regarding tobacco-related diseases: mobilizing the medical community to inform about the benefits of harm reduction, countering misinformation about nicotine and new products, reviewing legislation to simplify access to less harmful products, and establishing independent, science-based consumer and other advocacy organizations capable of representing their interests based on credible scientific research.