Tobacco harm reduction in Afghanistan: a recipe for improving smokers’ health

Abstract

Tobacco Harm Reduction (THR) offers a promising approach to addressing the significant burden of smoking in Afghanistan. Over three million Afghans smoke daily, making it a leading cause of preventable deaths in the country. While the previous Afghan government implemented various tobacco cessation policies and strategies, these measures were only partially effective in reducing the number of smokers or smoking-related deaths. In 2021, community-based initiatives in Kabul and Herat started advocating for Tobacco Harm Reduction (THR) as a novel, realistic, and practical approach proven to promote smoking abstinence and minimize tobacco harm. However, implementing THR strategies in Afghanistan faces numerous challenges, including a lack of governmental support, funding issues, unfavorable market conditions, the high cost-effectiveness of THR products, and misconceptions about these products. To effectively promote THR in Afghanistan and overcome these challenges, it will be necessary to implement THR policies that support THR products for smokers, regulate the market for these products, produce them locally with healthcare professional oversight, conduct more engaging advocacy campaigns, and secure domestic sponsors.

Cancer prevalence, incidence, and mortality rates in Afghanistan in 2020: A review study

“…While cigarette smoking is the most common form of tobacco consumption, other tobacco products, such as water pipes and smokeless tobacco are becoming widely popular, and their consumption is even increasing among young adults, implying an increase in LC burden shortly 60 . Unfortunately, tobacco products are widely available in Afghanistan, and smoking is socially accepted 61 . Outdoor and occupational exposure to asbestos, radon, polycyclic aromatic hydrocarbons, and arsenic, and indoor air pollution from secondhand smoking, unventilated coal‐fueled stoves, and cooking gasses have all been related to LC, especially in Afghanistan 62,63 …”

“…Smoking cessation and reducing exposure to indoor pollution are important strategies in the prevention of LC 64 . Extensive tobacco control programs have been effective in decreasing smoking rates, but since total abstinence programs have been considered a failure, combining abstinence programs with tobacco harm reduction programs can help lower smoking rates 61 …”

“…60 Unfortunately, tobacco products are widely available in Afghanistan, and smoking is socially accepted. 61 Outdoor and occupational exposure to asbestos, radon, polycyclic aromatic hydrocarbons, and arsenic, and indoor air pollution from secondhand smoking, unventilated coal-fueled stoves, and cooking gasses have all been related to LC, especially in Afghanistan. 62,63 Smoking cessation and reducing exposure to indoor pollution are important strategies in the prevention of LC.…”

“…64 Extensive tobacco control programs have been effective in decreasing smoking rates, but since total abstinence programs have been considered a failure, combining abstinence programs with tobacco harm reduction programs can help lower smoking rates. 61 Furthermore, implementing strict restrictions on outdoor air pollution and occupational exposure is crucial in Afghanistan. According to the findings of this study, women 15-39 is a higher incidence of LC than older ages.…”

Exploring the Relationship between Drug Addiction and Quality of Life in Herat, Afghanistan: A Cross-sectional Study

“…14 Afghanistan lacks effective policies for addiction treatment, and there is limited information in this regard. 15,16 Considering the elevated prevalence of drug addiction and its detrimental effects on the quality of life in Herat, Afghanistan, it is essential to comprehend the extent of this problem among affected individuals and their families. Accordingly, the objective of this study was to evaluate the quality of life of drug users in Herat and identify the factors that contribute to diminished quality of life within this particular population.…”