Tobacco harm reduction: The need for research to inform policy

Kuala Lumpur – The Federation of Private Medical Practitioners Associations Malaysia (FPMPAM), a national body representing doctors in private practice in Malaysia, today renewed its call to the Ministry of Health (MoH) to consider the science of harm reduction before rushing ahead with the generation endgame (GEG).

The proposed Bill, which is currently being reviewed by the Parliamentary Special Select Committee (PSSC), will ban the use and sale of cigarettes and vape products for those born after 2007.

Dr Steven Chow, President of theFederation of Private Medical Practitioners’ Associations Malaysia (FPMPAM)said, “There are many credible studies with supporting evidence for harm reduction. Public Health England and the Royal College of Physicians (Nicotine without smoke: Tobacco harm reduction2016) have authoritative reports documenting overwhelming scientific data that harm reduction efforts can work with proper regulatory framework in place. It is also pertinent to look at other new studies from other countries where harm reduction programmes have been in place for many years”

“In Malaysia, the field of tobacco harm reduction is in sore need for comprehensive basic clinical epidemiological research, and we must take the time and use our resources to explore this option. Rushing the GEG and excluding harm reduction from the policy would be a missed opportunity, as we may be losing out on an achievable option that can have a meaningful impact on the tobacco epidemic.”

FPMPAM further opined that general practitioners are key stakeholders that must be engaged when drafting the policy.

“The general practitioners (GPs) are the persons who are the first touch point for the patient. They are important because the patients have the confidence of their family doctor. Doctors trained in quit smoking programmes have the relevant expertise, experience and the nationwide network to engage with smokers. They understand the psyche of those wanting to quit. They are aware that it is not only the nicotine dependence/addiction that makes quitting cigarettes difficult. Some smoke for stress relief and other psycho-social pleasure. These issues do complicate the individual patient’s resolve to quit smoking. The GP is a key asset in any quit smoking programme and their input is valuable to the national GEG conversation.”

“In addition to engaging with stakeholders, the MoH must also look into conducting more methodologically sound clinical epidemiological studies on harm reduced products. Differences in the risk profiles of all non-combustion nicotine products need to be quantified and regulatory policies and clinical recommendations should be tailored to address their different risk profiles. Studies observing the health of long-term users of these products are also a must. Data from all these are pre-requisites studies must be available before one can develop a comprehensive and viable tobacco-free landscape for future generations.

“It will be disastrous if we have to do a u-turn on GEG five-years down the road.” Dr Steven concluded.

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