Consensus Statement : The Need for Tobacco Harm Reduction in India

Cigarette smoking is a major public health issue in India and leads to significant morbidity and mortality. Addressing the issue of smoking is a major challenge to public health, as the addiction is hard to break. Counseling smokers regarding smoking cessation is the first step to achieving cessation, but the quit rates remain low. Several pharmacological interventions have been developed over the years. Nicotine replacement therapy is available in a variety of formulations, each with different advantages, drawbacks, acceptability among smokers and quit rates. In addition, a range of novel nicotine and tobacco products, including Heated Tobacco Products (HTPs), have been developed which leverage nicotine to aid in smoking cessation. A group of medical experts convened to review the evidence on the burden of smoking, the concept of Tobacco Harm Reduction (THR), novel nicotine and tobacco products for THR, and the potential of HTPs to aid in smoking cessation. This paper outlines the findings and recommendations regarding THR in the Indian context. The panel opined that tobacco cessation centers and counseling remain the foundation of tobacco cessation in India. At the same time, there appears to be potential for the application of THR products in India. The relevant authorities must review the potential of THR products, and make these available, to provide the best possible cessation strategy for the Indian population that is currently at risk of mortality and severe morbidity.

Survey on Heated Tobacco Products in Smoking Prevention Education by School Pharmacists / 社会薬学

The number of heated tobacco product users is increasing rapidly in Japan; thus, smoking prevention education that includes heated tobacco products is necessary. To clarify the current status and issues related to smoking prevention education programs for school pharmacists, a questionnaire survey was conducted among 300 school pharmacists. The response rate was 45.3% (136/300). Smoking prevention education was provided by 42.6% (58/136) of school pharmacists. Among them, 56.9% (33/58) included heated tobacco products in their education programs. Moreover, 75.9% (44/58) of pharmacists also provided support for smoking cessation at pharmacies, and 93.1% (54/58) of pharmacists felt the necessity of providing support for smoking cessation for heated tobacco product users at pharmacies. On the other hand, 21.8% (17/78) of school pharmacists who did not provide smoking prevention education responded that they did not have sufficient information and knowledge about heated tobacco products. In addition, among these pharmacists, 53.8% (42/78) did not provide support for smoking cessation at pharmacies. Although both groups felt the need for the smoking prevention education provided by school pharmacists, the school pharmacists who provided such education felt the need more strongly. Regarding the necessity of including the taking up of heated tobacco products in smoking prevention education, it was found that pharmacists who provided such programs felt the necessity more strongly. It is important to obtain accurate information about heated tobacco products and change the content to unified educational in cooperation with schoolteachers to enhance smoking prevention education by school pharmacists.

The Government Policies of New Tobacco Products: Strategies for Managing Electronic Cigarettes and Heated Tobacco Products / 보건행정학회지

The term new tobacco products (NTPs) refers to the new alternatives to conventional cigarettes. There are several kinds of NTPs in South Korea. The present study discusses the most widely used NTPs namely electronic cigarette (ECs) and heated tobacco products (HTPs). The aims of this study are to evaluate the risk related to the use of ECs and HTPs, introduce policy examples across different countries of management of this issue, and finally, present some policy implications of the problem and our response strategies. Since the advent of ECs, there has been a lot of debate about its risk. Some studies have reported that ECs are less harmful than conventional cigarettes and that they are effective in aiding smoking cessation. Nevertheless, the efficacy of ECs in smoking cessation and its potential health risks are still unclear. However, the obvious fact is that it is not harmless. Regulations on ECs differ from country to country. In many countries, they are strictly regulated as tobacco or toxic substances; however, in the United Kingdom, the use of ECs are included as part of their smoking cessation policy, and in Japan, they are treated as a form of medication. On the other hand, HTPs are the most recently introduced NTPs and they have attained sensational popularity because of the wrongly held belief that they are less harmful to health. So, what about our policy response to these two tobacco products? The research on ECs requires more systematic statistical monitoring, such as monitoring the ratio of dual-users. Further, the new EC smokers should be identified taking into account that the arguments for the use of ECs often emphasize smoking cessation or less risks to health, the government should further strengthen its policy to prevent those claims. The HTPs market experienced a very sharp growth and continues to grow because the government policy is too passive. Taking this as a lesson, it is necessary to approach NTPs, such as HTPs, proactively and increase their contribution to the National Health Promotion Fund by imposing greater taxes on them. Finally, considering the likelihood of NTPs being promoted as a less harmful tobacco product, it is essential to strictly regulate tobacco companies' publicity from the very beginning to ensure that potential consumer s are not mislead.

Experience and Current Use of Heated Tobacco Products in Korean Military Personnel

BACKGROUND: Heat tobacco products (HTPs) are emerging in Korea. There are few studies that investigated the rates of HTPs use among military personnel in Korea. This study was performed to identify the prevalence of HTPs experience and use. Also this study aimed to evaluate the related factors of HTPs experience and use among military personnel in Korea.METHODS: The study subjects were 3,878 military personnel participated health survey for Korean soldiers from November to December in 2018. Binominal logistic regression analysis was performed to confirm the related factors of HTPs experience and use among military personnel in Korea.RESULTS: The HTPs experience and current use rates of study subjects were 17.4% and 8.7%, respectively. And the HTPs experience and current use among military personnel was associated with college/university degree (adjusted odds ratio [aOR] 1.441, 1.377), lance-corporal (aOR 2.049, 5.636), superiors' smoking in military camp (aOR 1.516, 1.567), interest in health (aOR 1.637, 1.571), ever used smoking (aOR 2.817, 3.575), and ever used electronic cigarette (E-cigarette) (aOR 3.129, 1.587).CONCLUSIONS: The HTPs experience and current use among military personnel are closely related to educational level, military level, smoking status of the superiors, interests in health, conventional cigarette smoking, and E-cigarette use.