Misinformation hinders tobacco harm reduction in LMIC countries, advocates say

Misinformation from international NGOs is one of the significant factors that prevent the adoption of tobacco harm reduction (THR) in the low and middle-income countries (LMIC), said harm reduction advocates.

Health-policy experts representing countries such as India, Ukraine, Kenya, and Mexico spoke about the obstacles to the adoption of THR in LMICs during the Global Forum on Nicotine held virtually from Liverpool in June, said a press release.

Mexican lawyer and harm reduction advocate, Tomás O'Gorman said that the ideological position being forced by international non-government organisations like Bloomberg Initiative and Campaign for Tobacco-Free Kids has been a big challenge to the adoption of harm reduction products like vaping to help smokers quit.  

"Another challenge I think we must overcome is the lack of information. There is no research in Mexico regarding safer alternatives. So, there is some misinformation and ignorance," said O'Gorman, co-founder of Pro-Vapeo Mexico, a Mexican consumer association that advocates for tobacco harm reduction and non-combustible alternatives.

A medical doctor and public health researcher, Dr Sree Sucharitha of India said that lack of political will for using tobacco harm reduction products like vaping to help 300 million smokers in India quit cigarette smoking.

She said that unavailability of THR products in the market also prevents the general public and health professional to learn about the opportunities and options available for quitting.

Nataliia Toropova, an international health expert from Ukraine, and former World Health Organization (WHO) tobacco-control programme coordinator, said that about 220,000 people in the Russian Federation die every year from smoking-related diseases.

"Yet, the harm reduction strategy in the region is absolutely missing. If we have to name three reasons why, the biggest obstacle to a harm reduction strategy I would say is the lack of objective solid information, evidence-based on the risk reduction products. There is simply no data, no information available to policy makers available to general public," said Toropova, who now runs international think tank "Healthy Initiatives" to promote and strengthen public health in Ukraine.

Tobacco harm reduction advocate Joseph Magerofrom Kenya said that public health policy, which is influenced by misinformation and lack of research is a big obstacle for the adoption of a harm reduction policy. The higher cost of THR products is another challenge, said Magero.

"The third challenge we're facing is a lack of support from WHO and FCTC. And then the last one is, of course, the Campaign for Tobacco-Free Kids and what they're doing here," he said, referring to a well-funded organization that vehemently opposes the use of safer nicotine products.

Magero is the chairman of Campaign For Safer Alternatives, a regional organization that advocates for the adoption of tobacco harm reduction policies in Africa. Toropova of Ukraine also slammed efforts by organizations like the American billionaire Mike Bloomberg funded Bloomberg Initiative (BI), which opposes use of tobacco harm reduction products to help smokers quit.

"That's a very huge issue for the APAC [Asia-Pacific] region. The BI attack is very, very obvious, and it has very negative impacts in our countries in terms of harm reduction products. It's basically about massive lies about harm reduction products," said Toropova. 

Dr Sucharitha said "philanthropic colonialism" was also present in India, with money from NGOs being pumped into shaping health and tobacco policies. Sucharitha said while tobacco harm reduction products are accepted in developed countries, they are being discredited in LMICs.

In Bangladesh, which is an LMIC, there is not active harm reduction initiative in public health policy. Advocates for harm reduction in Bangladesh say that a clear harm reduction policy could help Bangladesh achieve its goal of making the country tobacco free by 2040.