Need for science-based pragmatism rather than dogmatism to shape tobacco reduction policies, Health News, ET HealthWorld
This month marks World Health Day, April 7, an important day that highlights the importance of physical and mental health and well-being. With the theme “Our Planet, Our Health”, the pandemic has provided an opportunity to redefine health priorities and foster healthier societies. As the pandemic raged, the country also witnessed an increase in non-communicable diseases (NCDs) with an increase in cases of cancer, asthma and heart disease, further affecting national health systems.
Amid increased attention to health aligned with the Sustainable Development Goals (SDGs), managing NCDs has become a key health priority to ensure well-being as well as equitable access to healthcare.
The current pandemic offers many lessons in terms of the evolution of science and its impact on the implementation of public health policies. As the science on tobacco harm reduction evolves, public health policies need to keep pace with it. The pandemic has heightened the need for the Indian healthcare system to review current smoking cessation strategies, especially for patients who have suffered from COVID-19 as well as other non-communicable diseases including tuberculosis, heart disease, cancer or gastro-related health problems, not only by treating these diseases with medical treatments but also by including smoking cessation in these treatments. Here is an obligation and an opportunity too.
Adult smokers are often more prone to these conditions due to various cardiovascular consequences. When recovering from a non-communicable disease, these patients are more vulnerable and open to exploring other treatment options to improve their overall health and make better lifestyle choices. Unfortunately, most health care providers only focus on the said disease or provide simple advice to quit smoking and other substance addictions without providing or discussing adequate withdrawal options as part of treatment solutions. holistic. It is also imperative to understand that there is no one formula that applies to all. Each smoker has individual biogenetic and psychological characteristics due to which he is unable to make the change and quit smoking. It is necessary to consider different solutions for different people and evaluate safer alternatives on a case-by-case basis. It is crucial to provide consumers with safer alternatives giving them the right to choose the best solution that suits them.
Over the past 20 years, there has been ample data indicating the limited success of abstinence-based smoking cessation methods or nicotine replacement therapy (NRT) in countries including India . Despite having the second largest population of smokers in the world, the country continues to struggle to implement successful cessation programs with limited options in the form of nicotine patches or gum which have limited effectiveness.
Unfortunately, the ban on e-cigarettes and safer alternatives has deprived millions of adult smokers in India of access and the right to make informed decisions about safer tobacco harm reduction alternatives. From a health care provider’s perspective, such prohibitions also limit the ability of the medical fraternity to explore holistic treatment options, for different clients.
Another underlying factor of these substance addictions is not only the physical and behavioral ramifications, but also the impact on the mental well-being of these individuals. As per WHO classification and Indian Mental Health Act, all addictions should be considered mental health disorders, patients should be eligible for a full range of treatments to meet their needs. This gives the obligation to support addicted patients by providing them with progressive treatment options supported by technological advancements.
Unlike India, many international countries like UK, USA, Japan etc. readily adopted safer alternatives to complement other tobacco control measures to reduce adult smoking rates through well-planned, science-based regulations to supply millions of smokers, who would otherwise continue to smoke.
Today, it is widely recognized that safer alternatives have multiple benefits. Public Health England concluded in its report titled “E-Cigarettes: An update of the evidence” that “e-cigarettes are 95% less harmful than regular cigarettes”.
In addition, these safer alternatives also prevent the dangers of passive smoking, allowing families, colleagues and friends of adult smokers access to healthier environments.
As a society, we must follow science rather than dogmatism, investing in research and science and defining regulations that are progressive and benefit all stakeholders. Medical scientific evidence as well as a consumer rights perspective make it necessary to make the widest range of options available to people with tobacco dependence and their service providers.
By Prof. Dr. Nimesh G Desai, Senior Consultant in Psychiatry and Former IHBAS Director, Delhi.
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