Tobacco harm reduction: a physician’s perspective

Pakistan has been facing chronic public health challenges for a long time. One of the biggest challenges facing public health in Pakistan has been the widespread use of tobacco. Physicians witness the health impacts of smoking on people’s health, with anomalies varying from heart diseases to respiratory disorders and cancers on a daily basis. Tobacco-related diseases have caused a mammoth burden on the already frail healthcare system in Pakistan. What role can the physicians in Pakistan play to prevent them from falling into this pit? Our responsibility is not only to treat those who have already encountered the worst, our job is also to help and protect those who are vulnerable to become victim of such diseases. Undoubtedly, smoking cessation must be the focal point of all tobacco control efforts. Protecting the youth from the onset is another critical element and helping the smokers to quit will always deliver the best desired outcomes. Many smokers find it extremely difficult to quit smoking and their struggle to quit becomes arduous using conventional cessation methods. This is where doctors can and must play an extremely important role. As physicians we always back the scientific evidence and any approach that is substantiated by it. The same is true for tobacco harm reduction. The Pakistan Academy of Family Physicians (PAFP) firmly believes that the important decisions about health must be guided by patient-centric care, scientific integrity and an unwavering commitment to achieving best outcomes for society. As a health practitioner, and as a representative of PAFP, I can say that the academy remains steadfast in advancing this dialogue through a holistic three-tier approach: functional level, operational level and policy level. At the functional level, we need to focus inward in our fraternity and educate physicians and develop their practical clinical guidance and patient counselling on tobacco harm reduction. They must be aware and equipped with the effective and latest scientific tools as well as the best practices that are globally accepted as a standard. Operational level requires stronger collaboration with the government, academia, public health bodies and civil society. This will help fortify the quality of research, develop synergised surveillance systems, increase community awareness, ultimately leading to effective tobacco control outcomes. Whereas, at the policy level the academy is ever present to offer their guidance, clinical expertise and their insights on evidence-based policies that always put prevention first. The academy is also there to guide on regulation on emerging nicotine products, effective health policies that are backed by science, transparency and continuous evaluation. Our position as physicians is unique as we don’t just prescribe medicine; we are there to increase awareness, counsel and build trustworthy relationship with our patients and their families. Every consultation is an opportunity to give our patients an outlook of healthier choices and letting them know their options towards a smoke-free future. Our mission as Pakistan Academy of Family Physicians has a mission of working towards an advanced primary healthcare and supporting health priorities. Cross industrial discourse and collaboration within different institutions as well as evidence-based policymaking will enable Pakistan to reduce diseases by adopting strategies that work. As our journey continues, we reaffirm our commitment to prevention, evidence, collaboration and technological innovation. We can work together to reduce the burden of tobacco- related diseases on Pakistan’s healthcare system and making its future generations healthier. Copyright Business Recorder, 2026

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