Health Promotion Key In Public Health Policy Guiding Tobacco Harm Reduction

There are many factors behind the emerging smoking trends whereby kids end up smoking cigarettes before they even turn 18. These can be social, cultural or even economic. 2019 smoking data from statista.com shows that Bulgaria had 32 percent cigarette smoking prevalence among teens aged 13 to 15 years, the highest in the world at that time.

The lack of education, health promotion and effective communication has resulted in more young people from different parts of the world smoking combustible cigarettes at a very young age. Public Health literature has proven that comprehensive and active awareness of the population through health promotion strategies are the primary tools for smoking prevention and cessation. Public education is an integral part of the efforts to both prevent the initiation of smoking and encourage smoking cessation.

Speaking during a panel entitled “Policy Frameworks for Promoting Public Health” at the 7th Summit on Tobacco Harm Reduction, Dr. Piotr Karniej, a public health specialist from Poland said the lack of education and awareness on the harms of smoking combustible cigarettes was one of the leading causes for the high smoking prevalence in kids.

“The role of health promotion and health education especially in the context of Tobacco Harm Reduction is really important for us to talk about. We have to look at the effectiveness of everything we do in education and health policy. The most important problem is that health education and health promotion in Poland are not very efficient because the sector doesn’t have enough money,” said Dr Karniej.

He said health authorities such as the World Health Organisation (WHO) should use scientific language rather than antagonising tones when communicating the Tobacco Harm Reduction message.

Presenting data from a recent study regarding the consumption of nicotine products among 16–17-year-old young people, Dr. Karniej said that in Poland, the sale of nicotine products to persons under the age of 18 is strictly prohibited. However, these products are purchased by teenagers, among others, via the grey market, social media, instant messaging and websites selling illegal nicotine products, as well as through friends or older colleagues. 62% of adolescents who use nicotine products have already taken up nicotine for the first time between the ages of 12 and 15, and most of them had already had experience with the cheapest traditional cigarettes before reaching for disposable e-cigarettes.

“Most of these kids have already had an experience with traditional cigarettes before reaching for disposable cigarettes. Contrary to the belief that disposable cigarettes are the first step for initiation for users, this report shows that this is not true, and that very young people between 12 and 15 are starting from the cheapest solution of the nicotine that is cigarettes.”

According to the same report, the most common reason for young people to use nicotine products is to relieve stress, as cited by 60% of respondents in the 16-17 age group. This points not only to the need for preventive measures in the context of nicotine use, but also in the context of psychiatry, coping with stress and relieving tension.

Young people, the speaker stressed, are not able to cope with everyday tension and stress. More than half of those respondents will not give up e-cigarettes if they disappear from legal outlets. 49% of respondents will stop using them, but 20% will look for other products of this type and 32% will look for other distribution channels, which opens the path for illegal imports of nicotine products from countries like China.

Dr. Karniej urged governments all around the world to take into account the real and not the imaginary circumstances of tobacco use, including products available through illegal channels.

Meanwhile, Malaysia had a huge problem several years ago with the amount and percentage of smokers. However, the situation has improved compared to the neighbouring countries, such as Indonesia, owing to Malaysia’s story of success in tobacco control.

Professor Sharifa Ezat Wan Puteh, a Medical Doctor from UKM in Malaysia said health promotion the world over is ‘mum’ on the Tobacco Harm Reduction discourse.

“Currently there are a lot of problems in health promotion. Not saying health promotion is not a high priority. It’s just that Tobacco Harm Reduction is not seen as something welcoming in many countries including Malaysia. We have problems trying to convince our policymakers and students that Harm Reduction also includes Tobacco Harm Reduction. They would not endorse it and they do not look at tobacco harm reduction as an effective tool,” she said.

She added that many government societies have adopted the perfectionist view, according to which no form of tobacco or use of nicotine should be allowed. For tobacco addicts, they only propose NRT, which can be purchased over the counter from pharmacies but does not actually work in the real world, she commented.

She also said that Tobacco Control policies in Malaysia were relatively good with the key elements of their success being education, training, and law enforcement. Enforcement is quite strong, she explained, and takes a lot of the country’s budget. Unfortunately, there is also a high percentage of illegal cigarettes in the region.

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