Dhaka Tribune held a roundtable session, in collaboration with Asia Harm Reduction Alliance, titled “The role of Tobacco Harm Reduction (THR) in achieving Hon'ble Prime Minister's Smoke-free Bangladesh vision by 2040” in Dhaka, on Saturday.
The panel consisted of leading tobacco harm reduction experts, including international public health advocates, policymakers, academics, and consumers. The objective of the roundtable was to discuss the concept of THR, the science-based evidence for harm reduction tools, global best practices, and how Bangladesh can become an international role model by adopting a THR framework in its upcoming National 9th Five Year Plan to achieve the honourable prime minister's vision of a smoke-free Bangladesh by 2040.
Harm reduction is a widely accepted framework endorsed by progressive nations around the world, to reduce smoking-related deaths. The THR framework has proven its efficacy in encouraging policymakers to develop and enact risk-proportionate regulations for less harmful alternatives of nicotine delivery such as vaping devices, e-cigarettes, oral nicotine, heated tobacco products and others to achieve their smoke-free ambitions.
Dr Konstantinos Farsalinos, a cardiologist and the most cited tobacco harm reduction researcher, said Bangladesh can become an example in the South Asian region of successfully adopting tobacco harm reduction and pave the way for neighbouring countries.
He argued that THR should be “actively endorsed as the solution” to achieve a smoke-free Bangladesh as it is “Bangladesh's last and only option.” The THR framework addresses the key causes of smoking related health issues by focusing on eliminating combustion and the harmful effects of smoke and tar.
Dr Marewa Glover, director at the Centre for Research Excellence: Indigenous Sovereignty and Smoking, shared insights on New Zealand's experience with the reduction of smoking. She stressed the importance of education as the first step, as smoking is highly addictive and simply urging individuals to quit is insufficient.
She advocated for a holistic perspective, and the importance of comparing relative risks; focusing on where the harm is greatest. Furthermore, she mentioned that solutions like vaping have been around for 20 years with very little evidence of harm, suggesting that longer-term reduced-risk products like vapes should be considered.
As Dr Delon Human, a former secretary general of World Medical Association, said, achieving the “smoke-free” status requires a country to have a smoking prevalence of 5% or less among the adult population. Currently, Bangladesh faces a considerable hurdle with a smoking prevalence of approximately 20.9%, reaching 40% among adult males.
Dr Human pointed out that transitioning towards a smoke-free nation becomes not only a public health imperative but also an economic one. “According to the Centre for Economics and Business Research, the UK government has earned £310 million in 2021 as tax revenue from the vaping industry alone.”
He stressed that “the tobacco harm reduction policy framework should be made part of Bangladesh's macroeconomic planning strategy -- the National 9th Five Year Plan in 2024” as public health policies and economic policies cannot be “decoupled.”
Prof Dr Mohammad Mizanul Haque Kazal, secretary general of Bangladesh Agricultural Economist Association said the three key steps to achieving a smoke-free Bangladesh are agricultural product diversification, increasing social awareness and support, and implementing proper regulations.”
Prof Dr Lutful Hassan, Vice-Chancellor, Bangladesh Agricultural University said, “Vaping or e-cigarettes are 95% less harmful than the traditional cigarettes.” But he insisted on conducting further research to see how vaping can be implemented and how the government may regulate it.
Major Dr AKM Mahbubul Haque (retd) emphasized that relying solely on legislation is insufficient to tackle this issue. We need a comprehensive approach which encompasses broader social interventions to effectively combat this crisis. He said, “We need smoke-free households, peer support, and social awareness. I believe local public health advocates, doctors and experts need to play a crucial role to help consumers in their quitting journey.”
Prof Dr Md Abdur Razzaque, Director (Research), Sher-e-Bangla Agricultural University Research System said, “The government must focus on the science-based evidence before taking any decision.”
Masud-Uz-Zaman, Convener, Voice of Vapers Bangladesh drew from his personal experience on quitting smoking and said, “Vaping should be encouraged for people to stop smoking.”
Prof Dr AKM Zakir Hossain Vice-Chancellor -- KAU, reiterated the need for sensible policies, product safety standards, social and cultural awareness, and a progressive framework of government regulations for less harmful alternatives like vapes, oral nicotine and others to ensure the protection of public health.
Syed Zain Al-Mahmood, Executive Director, Center for Communication Action Bangladesh moderated the roundtable discussion.