Philippines, UK call for science-based approach to address smoking problem – When can Pakistan follow suit?

Secretary of Foreign Affairs of the Philippines, Teodoro Locsin Jr., has urged WHO to consider “evolving and latest scientific information” to accelerate reduction in the global smoking incidence, adding that Philippines shall also be adopting the same approach in tackling its smoking problem.
These views were expressed during Locsin’s address to the delegates at the opening of the ninth Conference of Parties (COP 9) of the World Health Organization’s Framework Convention on Tobacco Control (WHO FCTC) that took place virtually last week.
Referring to the less harmful alternatives to cigarettes now available in the market, Philippines Foreign Affairs Secretary pointed out how the tobacco industry has introduced “products with similar satisfaction but with far less harm” to gradually phase out cigarettes. He further presented Philippines’ stance on the matter and said that his country is against the culture of total ban and instead, stands for regulation and taxation.
However, to prevent any unintended use of the products, he said that Philippines has passed two more excise tax laws to cover the “far less harmful novel tobacco products,” banning the sales of e-cigarettes to minors and flavorings on vapor products. These regulations are important as they “recognize the fundamental difference between various tobacco and nicotine products”, he added.
Such an approach from Philippines is a prime example of how regulators should develop policies based on relevant scientific evidence.
Smoking is one the leading causes of preventable deaths worldwide. Smokeless products, such as nicotine pouches, e-cigarettes and Heated Tobacco Products provide a less harmful alternative to smokers who would otherwise continue smoking cigarettes, as also proven by multiple scientific researches. Many experts and health authorities from around the world such as the UK’s Royal College of Physicians have recognized that smoke-free alternatives to cigarettes represent a revolutionary opportunity to reduce the harm caused by cigarette smoking. As per a report by Public Health England, e-cigarettes are 95 percent less harmful than cigarettes. Yet, policy makers continue to overlook this evidence and deny adult smokers the option to switch to better alternatives.
Pakistan faces a heavy burden of disease because of combustible smoking, with more than 25 million users of tobacco in the country. The total cost of all smoking-attributable to diseases and deaths in 2019 in Pakistan was $3.85 billion.
A panel of experts speaking at a consultation session arranged in Karachi by the Alternative Research Initiative (ARI) Pakistan were of the opinion that Pakistan also needs to provide effective and affordable smoking cessation services and make tobacco harm reduction part of the national policy, by incorporating innovative solutions for ending smoking: whether through counselling, NRTs, or harm reduction.
The experts said that tobacco harm reduction works as almost all of the disease risk attributable to smoking arises from the smoke: the particles of tar and toxic gases that are inhaled from burning tobacco. If smokers can find satisfactory alternatives to cigarettes that do not involve combustion but do provide nicotine, then they would avoid almost all of the disease risks.
The participants regretted that smokers’ concerns have been ignored in Pakistan’s tobacco control efforts. Smokers in Pakistan are on their own when it comes to quitting smoking. If they decide to give up smoking, they don’t know where they should seek assistance. That is why less than 3 per cent of smokers successfully quit smoking in a year in Pakistan.
The speakers maintained that a smoke-free Pakistan is possible to achieve before 2030 provided the country ensures effective cessation services are accessible and affordable, and the tobacco harm reduction is made part of the national tobacco control policy. The participants also called for sensibly regulating innovative tobacco harm products in Pakistan.
Despite many tobacco control efforts made in the past, there have been limited efforts based on relevant scientific considerations, as a result the desired result in terms of reduced burden on public health has not been achieved yet. Countries like UK, US, Japan, and Thailand have already shown significant decline in their number of smokers with their progressive regulations on less harmful alternatives, while other countries like the Philippines are also turning to science to deal with their smoking problem. It is about time that Pakistan also follows suit.

— The writer, based in Karachi, can be reached at

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