Ignorance is bliss?
This is the 21st century – the age of information and ignorance is not bliss anymore. Today, what you do not know will definitely hurt you, especially when it is about your health and wellbeing. And yet, behavioural health illiteracy is on the rise in our country. Take the example of millions of smokers in Pakistan who are left unattended and uninformed beyond mere advice and warnings to stop smoking. As a result, while every year around 25 per cent smokers make an attempt to quit smoking in Pakistan, the success rate is only 2.6 per cent – one of the lowest in the world, while the rest become victims of relapse. Most of the time, people who are indulging in unhealthy behaviours and habits are clueless about the possible avenues of help that could equip them with strategies that they can undertake to cope better with their situation and help them get rid of their unhealthy habits. The lack of infrastructure to support or provide adequate assistance is another part of the problem, bringing people to a dead-end in their search of a plausible solution and thus, leaving them with no choice but to suffer.
Harm reduction, an evidence-based and client-centered approach that seeks to reduce the negative health and social impact associated with problematic habits, without demanding immediate abstinence, is one of the most popular practices across many countries in terms of harmful behaviours, which is now even being used in a wider scope of individual and social issues. However, in Pakistan, the use of this approach has been quite limited and minimal. Consequently, smokers are either forced to observe absolute cessation or are left unguided to navigate out of their problem on their own. While most certainly abstinence-only services should be available as part of a range of options, this should not be the only approach or the single standard of practice. In fact, one could argue that in some ways, strict adherence to abstinence-only can backfire for some people depending on the extent of their problem.
To avoid relapse and help smokers who are unwilling to quit, there are several reduced risk products. Heated tobacco products, vapes or e-cigarettes are less harmful than conventional cigarettes and are a more practical solution to reducing the ill-effects of cigarette smoking. In several countries such as Japan tobacco harm reduction strategies have proven to bring down the rate of smoking substantially by making reduced-risk products available to adult smokers for whom quitting was not a viable option. Thus, although harm reduction may not be the perfect solution, it is a practical tool to help them along the way.
Another upside to the availability of information and access to alternate resources is the increased chance of encouraging people, who have not thought about quitting their habit yet, to at least switch to less harmful products. If adequate avenues are offered and necessary information is provided about possible routes, there may be a substantial rise in the number of people trying to improve their lifestyle. Harm reduction is, therefore, a client-driven approach that respects individual choice, and opens the possibility for many individuals who choose to continue smoking but are concerned about the impact on their health.
The need is, now, for policy makers to study the role of harm reduction in improving public health across different countries and experiment with these innovations. Educating masses about different options and making these options available may help them to steer their way towards a healthier lifestyle through their own informed decisions, trumping their ignorance with science-backed information and making knowledge a true bliss for them.
— A contributor