Rethinking Tobacco Control: Why WHO must embrace harm reduction

The World Health Organization (WHO) is pivotal in global tobacco control efforts. With 1.3 billion smokers worldwide and the 2030 deadline for achieving Sustainable Development Goal (SDG) Target 3. drawing closer, the urgency to reduce smoking rates has never been greater. However, despite the strict regulations outlined in the Framework Convention on Tobacco Control (FCTC), smoking prevalence remains high in many countries, including Pakistan.

In December 2024, the WHO held its third high-level leadership program in Lyon, bringing together representatives from 10 countries, including Pakistan, to strengthen tobacco control policies. However, the organization continued to rely on the same restrictive measures – high taxation and outright bans – despite their limited success in significantly lowering smoking rates. What remains overlooked is the success of countries that have adopted tobacco harm reduction (THR) strategies to complement tobacco control measures.

Pakistan, with its high smoking rates, faces unique challenges. Despite stringent regulations, many smokers continue to smoke, either due to addiction or the easy availability of illicit products. Providing greater awareness and access to scientifically backed smoke-free alternatives – such as heated tobacco products, vapes, and oral nicotine pouches, which are already available in the market – could help adult smokers transition away from smoking while reducing exposure to harmful chemicals.

WHO can shift its approach by integrating THR into its global strategy. Instead of resisting better alternatives, the organization should support evidence-based policies, encourage research on their effectiveness, and facilitate collaboration between governments, public health organizations, and industry stakeholders to ensure product safety and accessibility.

Future WHO leadership programs must incorporate THR into their discussions to truly make an impact. These programs should equip country representatives with the necessary knowledge about smoke-free options and their potential role in reducing smoking rates. By fostering a more balanced and informed approach, WHO can empower countries to implement policies that reflect scientific evidence and real-world success stories. (By Sara Ghani)

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