International Tobacco Harm Reduction Advocates Urge Bangladesh to Reconsider Ban Proposal

A group of international advocates for harm reduction in tobacco have written a letter to the Ministry of Health, calling on the authorities in Bangladesh to reconsider their proposed ban on electronic cigarettes and other smokeless nicotine alternatives.

The letter points out that smokeless nicotine products have the potential to help people quit smoking, and urges the Bangladesh government to ban less harmful cigarette alternatives.

The Bangladeshi government should encourage a shift from traditional cigarettes to e-cigarettes on a large scale and take swift action to minimize illnesses related to smoking, in order to protect smokers. This is according to a statement released.

According to the letter, the authorities in Bangladesh should establish a science-based tobacco control and harm reduction policy, which would "result in public health benefits.

This letter is a response to the recent discussions around the 2013 revision of the 2005 Smoking and Tobacco Products (Control) Act, which includes a new "ban on electronic cigarettes.

The author of this letter believes that the proposed ban would have an impact on protecting the major tobacco companies' cigarette trade and existing commercial interests, even as these companies are attempting to shift towards marketing lower-risk products.

The letter requests that the government of Bangladesh "accept reduced-harm tobacco products as a part of tobacco control in Bangladesh," stating that this "will meet the needs of those who cannot or are unwilling to quit smoking altogether.

The author warned that banning or excessively regulating e-cigarettes without considering the impact on smoking, could easily exacerbate the harm to public health by either sustaining smoking or stimulating black market activity.

The letter urges government authorities to adopt a proportionate approach in regulating electronic cigarettes to address the health issues caused by traditional tobacco cigarettes.

It is suggested that electronic cigarettes should be used to reduce smoking, which is the primary form of tobacco use in Bangladesh. The article emphasizes that electronic cigarettes should be seen as an opportunity rather than a risk.

The letter also provides several pieces of scientific evidence indicating that the harm caused by electronic cigarettes is far less than that of smoking.

In 2018, independent experts from the UK Public Health Department reviewed biomarker data and came to the conclusion that vaping only poses a small fraction of the risk of smoking, and completely switching from smoking to vaping can bring significant health benefits. Based on current knowledge, highlighting that vaping is at least 95% less harmful than smoking is an effective way to communicate the large differences in relative risk, and can encourage more smokers to make the switch to vaping, the letter states.

The letter urges Bangladesh to establish adequate regulations in line with the risks associated with tobacco, emphasizing that the primary objective of the country's tobacco policy should be to prevent and control the high rates of mortality and morbidity associated with tobacco.

The new regulatory system can set age limits, product standards, labeling, marketing and usage restrictions at its discretion, rather than imposing outright bans. The letter suggests that Bangladesh has the opportunity to learn from the experiences of the UK, EU and other places where there are valuable lessons to be learned.

Experts emphasize that in the proportional risk approach, products with the highest risk face the strictest regulations, while substitutes with lower risk face fewer and lighter restrictions.

Prohibition is the worst policy choice as it deprives law-abiding smokers of safer options, creates a black market, increases crime and corruption, ultimately burdening law enforcement agencies.

The main form of tobacco use in Bangladesh is through the use of e-cigarettes, which should be used as a means to reduce smoking, according to a letter. The letter indicates that e-cigarettes should be viewed as an opportunity rather than a risk.

The letter was signed by 17 individuals, including Dr. Delon Human, a former advisor to both the Director-General of the World Health Organization and the United Nations Secretary-General Ban Ki-moon.

Other signatories include Dr. Andres Milton, President of the European Red Cross and Red Crescent Network on HIV/AIDS and Tuberculosis, as well as scholars from Sweden, New Zealand, and Germany such as Professor Marewa Glover of Public Health at the University of Auckland and Professor Heino Stöver of Social Science Addiction Research at Frankfurt University of Applied Sciences.

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