Reducing Healthcare Burden Through Tobacco Harm Reduction: A Sustainable Solution for Pakistan

Smoking is one of Pakistan’s most pressing public health issues, leading to over 160,000 deaths every year. Despite being a signatory to the WHO Framework Convention on Tobacco Control (FCTC), Pakistan’s high smoking prevalence persists, compounded by policies that equate Tobacco Harm Reduction (THR) products, such as vapes, heated tobacco products, and oral nicotine pouches with smoking.

By reframing THR within a more supportive regulatory framework, Pakistan has an opportunity to reduce healthcare costs and smoking-related illnesses.

The economic burden of smoking-related diseases – cancer, heart disease, and respiratory illnesses –imposes immense costs on Pakistan’s healthcare system. Treating these conditions costs an estimated Rs615.07 billion, representing 1.6% of the country’s GDP. This growing financial strain impacts the country’s ability to fund other vital sectors, creating a cycle in which limited resources are consumed by preventable illnesses. Addressing smoking prevalence through THR could help break this cycle, reducing both the immediate and long-term costs associated with smoking-related diseases. 

Countries adopting THR policies have seen significant reductions in smoking rates. A report titled “Integrating Harm Reduction into Tobacco Control” projects that embracing THR products in Pakistan could reduce smoking prevalence from 34.3% to 8% by 2045 and to 5% by 2060. This shift could generate substantial healthcare savings, enabling investment in areas such as education and infrastructure.

Dr. Garrett McGovern, addiction specialist and medical director of Priority Medical Clinic, Dublin, Ireland states that harm reduction is the cornerstone of everything that is done in medicine. There are few things in medicine that can be cured, and all that can be done is to reduce symptomatology. The WHO’s negative stance on tobacco harm reduction is lacking evidence and increases the risk of harm to people who smoke.”To fully understand the long-term financial benefits of THR, Pakistan should consider conducting economic studies to model potential healthcare savings from a large-scale switch to harm reduction products. Moreover, for THR to reach its potential in reducing smoking prevalence, it must be affordable and accessible. Government-led subsidies and tax reductions on THR products would make these alternatives more accessible.

Launching public awareness campaigns to educate smokers on the reduced risks of smoke-free products is critical for their acceptance. Partnering with healthcare professionals and NGOs to disseminate accurate information and counter misconceptions would further build trust in these alternatives. Engaging global THR experts to learn from successful strategies could help adapt them to Pakistan’s unique context, maximizing their effectiveness.