Tobacco-related diseases claim approximately 160,000 lives annually in Pakistan, underscoring a critical public health challenge. Despite various efforts to curb tobacco consumption, existing strategies have proven inadequate in tackling the scale of the problem. There is an urgent need for a more effective approach, and the Swedish model of harm reduction presents a promising solution. This innovative strategy has significantly reduced smoking rates in Sweden and offers Pakistan an opportunity to enhance its tobacco control efforts.

Tobacco harm reduction (THR) focuses on lowering the health risks associated with tobacco use by promoting less harmful alternatives. Sweden’s success with this approach is evident. The introduction of snus—a smokeless tobacco product—has contributed to reducing the country’s smoking rate to just 5%. This success highlights the potential benefits of adopting similar strategies in Pakistan, where tobacco use is widespread and continues to pose a major health risk.

The potential impact of THR in Pakistan is substantial. By adopting THR measures, approximately 1.2 million lives could be saved between 2020 and 2060. A recent report by international and local Tobacco Harm Reduction experts, titled *Lives Saved: Integrating Harm Reduction into Tobacco Control*, explores several scenarios comparing current tobacco control measures with those incorporating THR strategies. For example, combining THR measures with early diagnosis and treatment of lung cancer could significantly reduce tobacco-related deaths, improving public health outcomes.

The report offers compelling statistics that underscore the urgency of adopting THR. In Bangladesh, implementing THR could save 920,000 lives; in South Africa, an estimated 320,000 lives could be saved, while Kazakhstan could see 165,000 fewer deaths. These figures highlight the global potential of THR to deliver significant health improvements and demonstrate the possible benefits for Pakistan.

Currently, Pakistan has 23.9 million regular smokers, 15.9 million smokeless tobacco users, and 6.2% of the population engaged in vaping. These numbers emphasise the need for innovative approaches to reduce smoking rates and prevent tobacco-related diseases. Introducing THR strategies, such as nicotine pouches and other less harmful alternatives, could offer a viable solution to the challenges faced by Pakistan’s tobacco control efforts.

The report also stresses the importance of timely adoption of THR. The spread of new technologies typically follows a classic innovation curve, where higher-income urban consumers are the first to adopt, with broader populations following. In Pakistan, early adoption of THR products could accelerate progress, with significant reductions in smoking-related deaths becoming evident within two decades.

Sweden’s experience with THR offers a compelling example for Pakistan. The Swedish model shows that regulatory support and targeted public health strategies can dramatically reduce smoking rates and associated health impacts. By adopting similar measures, Pakistan has the potential to address the severe health challenges posed by tobacco use and significantly improve public health outcomes.

Moreover, integrating THR into Pakistan’s tobacco control strategy would not only align the country with successful international models but also address the unique challenges it faces. With a comprehensive approach that includes harm reduction, Pakistan could make substantial progress in reducing tobacco-related mortality and morbidity.

Pakistan stands at a critical juncture in its fight against tobacco use. By incorporating harm reduction strategies and learning from successful models like Sweden’s, the country can achieve significant progress in improving public health and reducing the burden of tobacco-related diseases. The report’s findings underscore the transformative potential of THR in saving millions of lives, making it an essential component of Pakistan’s strategy to combat tobacco use and safeguard public health. The adoption of THR could represent a pivotal shift in the country’s approach to tobacco control, leading to a healthier and more resilient population.

Zabir Saeed Badar
The writer is a senior journalist, author, analyst, and researcher, with extensive teaching experience at major universities.