Adopting a Smoking Cessation Approach to Save Lives, Need to Revisit the Ban

On the back of three years of the ban on Electronic Nicotine Delivery Systems (ENDs), the fifth edition of ET Consumer Freedom Conclave, an interactive thought leadership platform, saw insightful discussion and debate on the need for an effective and cohesive smoking cessation approach to improve public health was held. Based on the theme of ‘Adopting a Smoking Cessation Approach to Save Lives’, the summit saw participation from eminent regulatory voices, policymakers, academia, scientific and medical experts, legal, think tanks, and consumer organizations amongst others who shared their perspectives on consumer freedom and the need for legitimizing alternate harm reduction products to aid smokers to reduce or eliminate their health risks.

Delivering his keynote address, Prof. M.V. Rajeev Gowda, Ex-Member of Parliament, Rajya Sabha said, “India is missing a public health opportunity of reducing harm with the expansive ban on the broad category of electronic nicotine delivery systems (ENDs). Such bans are driving the rise in illicit trade methods and encouraging black market. Additionally, it comes in the way of innovation, as these products can be helpful for smokers to phase out their addiction to cigarettes and enable them in quitting smoking. India can take many learnings from other countries which are taking strong strides in their journey to build a smoking cessation category by adopting science-backed policies enabling consumers to make a choice to switch to less harmful alternatives. Using ENDs or heat-not-burn devices can significantly reduce harm, and improve public health. It is time to re-think this ban and rather adopt the policy of regulation.” During a discussion on role of progressive policies in helping countries achieve its public health goals, Dr. Kiran Melkote, Orthopaedic surgeon based in Delhi, India, and member of AHRER – Association for Harm Reduction, Education and Research said, “On an average it takes smokers 30 attempts to quit and the large majority never manages to do so as the likelihood of quitting decreases with each attempt. The ban on ENDs has only managed to remove a competitor for cigarettes and cemented the tobacco industry in India. The inclusion of Nicotine Replacement Therapies (NRT) in the National List of Essential Medicines (NLEM) is a step in the right direction, however, we need to keep progressing on such policies. Lastly, while drafting laws there must be a representation of tobacco users to understand their fears and aspirations into account which is lacking at the moment.”

Sharing his perspective on how people can better sensitize both the lawmakers and the population on the benefits of switching to less harmful alternatives, Prof Dr. Nimesh G Desai, Senior Consultant in Psychiatry, and former Director IHBAS said, “In the last 30-40 years, there have been progressive policies and programs for tobacco control and harm reduction by the Government. Addictions related to alcohol and tobacco can be defined as bio-behavioural disorders which unfortunately also bring significant social and moral dimensions. For products where we have equivocal evidence, regulation is a much better approach than an outright ban.” Upendra N Sharma, Partner, JSA Advocates & Solicitors shares, “India needs to strengthen dialogue on regulation and adopt policies that will help achieve the larger national goals and objectives. Today, banned products are available in the grey market resulting in revenue loss for the exchequer. Additionally, there is no control on quality and youth of any age has access to it.”

Sharing his views on the leading challenges of substance abuse in the context of quitting cold turkey or finding alternatives, Charles A. Gardner, PhD, Executive Director, INNCO said, “Every smoker is different, one size does not fit all. Contrary to the belief that more alternatives will increase nicotine usage or dependency, more options to quit a deadly product is always better. We must encourage people to move away from toxic forms of tobacco and nicotine use. There is a need to understand that nicotine is not carcinogenic or does not cause other health problems usually associated with smoking. Such misinformation is the biggest impediment in the public mind but also in policymakers to bring about a positive shift in society.” During a discussion on legitimizing alternate healthier products as a strategy to help smokers reduce or eliminate their health risks, Dr Bharat Gopal, Senior Pulmonologist & Director, National Chest Centre, New Delhi said, “There is a very large unmet need where we are not able to extend help to smokers who wish to quit. Many times the only advice we can give is to quit or die. Whereas, the ideal way would be to provide less harmful alternatives to those who are unable to quit smoking. Harm reduction as part of quitting smoking is a critical aspect that needs to be looked at in a much holistic and integrated way.” The summit also highlighted some consumer stories where individuals shared their experiences around smoking and their willingness to quit, however despite trying alternatives such as lozenges, patches, etc. they were unsuccessful in their endeavor. These individuals were unanimous in stating that it will be better to have safer alternatives available in the market which can help them reduce the harm and eventually, give up smoking altogether.