As the world observes the 30th World No Tobacco Day tomorrow (31 May), it is important to acknowledge the progress that has been accomplished to reduce smoking rates. However, we still face many challenges as we aim to end this global epidemic.
While many people believe smoking is becoming less prevalent, there is the same number of smokers today, a billion, as there was a decade ago, mainly due to a combination of population growth and increased cigarette consumption in several regions of the world.
A billion people will die this century from cigarette smoking if the status quo is maintained. This is not acceptable. How can we do more and what can we do differently?
Approaching the problem of ending smoking as we have been doing – using regulations, taxation, and scare tactics – has yielded valuable results. These actions are necessary but not sufficient.
We need to approach the problem of curbing smoking from the perspective of the smoker. They need far more effective cessation options. Millions of adult smokers would benefit from better research on harm-reduction strategies.
Harm reduction is included in the preamble of the WHO Framework Convention on Tobacco Control, but we have not been focusing our efforts on it. If we want to realize a day with no cigarettes, we must complement current efforts with new and innovative approaches and research.
When we take a step back and look at smoking through the lens of the smoker, we see that many smokers actually smoke because they gain some pleasure from smoking.
That being said, they are also aware of the addiction and harm incurred by smoking. We have sought to understand the problem as seen by the smokers in several countries, and we listened to them.
Let’s take a look at the situation in India, for instance. Sixty percent of smokers in India consider themselves addicted and 69 percent of smokers also understand that smoking harms them.
The majority of smokers considered these points, amongst others like the price of cigarettes, as quitting drivers. However, 41 percent of smokers who have tried to quit smoking reported that they would need to seek assistance to do so.
We found that 44 percent of smokers incorrectly believe that nicotine causes mouth cancer. We must use their views to drive our focus on efficacious cessation strategies, and research harm-reduction products that can serve as smoking cessation tools.
Unfortunately, traditional tobacco control measures such as taxation are ineffective in India because 80 per cent of tobacco use in India is in the form of bidis, which are a type of low-cost, hand-rolled, locally-made cigarette.
They are less taxed than conventional cigarettes, which may account for their popularity. Compounding the problem, according to the CDC, bidis have higher concentrations of nicotine, tar, and carbon monoxide than conventional cigarettes.
Tobacco control approaches distinct than those applied to conventional cigarettes may have to be applied in order to accelerate the rate of smoking cessation and harm reduction in India.
To effectively accelerate the decline in the prevalence of smoking worldwide, we need to invest our efforts in better cessation tools, reduced harm products, and better product regulation. The time is ripe to initiate this work.
This World No Tobacco Day let’s listen to smokers to understand why they smoke, what challenges they face as they struggle to quit, what might help them successfully reach their goal to reduce the harm caused by cigarettes, and to ultimately quit or switch to reduced harm products. If we do, we are more likely to end smoking worldwide and see World No Tobacco Days as a commemoration of the past.
The writer is a global health expert and the President of Foundation for a Smoke-Free World.