
In a world battling cardiovascular disease claiming millions of lives, addressing addictive habits, particularly smoking, becomes a global priority. Our vision encompasses the intersection of innovative smoking cessation strategies, harm reduction, and cardiovascular health improvement. India, a nation grappling with approximately 120 million smokers with its staggering smoking population, stands as a crucial player on this stage. Let’s examine the potential of government policies to drive India towards a smoke-free future, thereby helping reduce the burden of cardiovascular diseases. The government should take decisive steps in formulating effective measures.
Cardiovascular disease: The role of risk factors and government policies

Globally, cardiovascular disease causes severe health burdens. This multifaceted challenge links genetic influences, blood pressure, lipid levels, and lifestyle elements like diet, obesity, physical inactivity, and smoking. The latter adds an ominous layer with its stubborn persistence overshadowing public health despite evidence proving its dire consequences. The question arises: why do modifiable risk factors often remain unaltered?
Modifiable risk factors hold immense transformative potential. Many individuals have successfully quit smoking and reduced alcohol consumption to improve their health. However, the reality is that there are still one billion smokers worldwide, aware of the dangers of smoking yet unable to break free from addiction. This collective failure highlights the need for innovative approaches.

Harm reduction emerges as a beacon of hope in this seemingly insurmountable challenge. Products like Snus, and heated tobacco offer a promising alternative. By heating tobacco instead of burning it, these products avoid the creation of harmful carcinogens, reducing the risk of harm by up to 95 per cent.

This issue raises the question – How can the government intervene and make these modifiable risk factors truly modifiable?
Innovative harm reduction: A gateway to hope
As we grapple with this quandary, a solution arises – a shift from traditional risk elimination to risk reduction. Forward-thinking substitutes such as Snus, and heated tobacco products emerge as potential saviours. By eliminating burning tobacco and substituting it with a heating process, harmful carcinogens are significantly minimized.
The intersection of smoking cessation and harm reduction holds immense promise in addressing global cardiovascular health challenges. While smoking remains a formidable risk factor, harm reduction strategies provide hope for those struggling to quit.
Misconceptions about nicotine, often painted as a villain, need rectifying. Nicotine is not the enemy but an abused and misunderstood stimulant, similar to caffeine when isolated from the act of smoking.
Government’s role: Observing the UK and US approaches
Both the UK and the US government have moved beyond acknowledging the viability of harm reduction. The UK incentivizes smokers to switch to lower-risk alternatives, resulting in a commendable 5 per cent decrease in the smoking population. Similarly, the US FDA has made cautious strides towards acknowledging the merits of reduced-risk products.
The needed path for India: Government intervention
Government policies can act as a lifebuoy for India, presently at a crossroads in the fight against smoking-induced cardiovascular health risks. Public health policies grounded in reliable scientific evidence can revolutionise smoking cessation programmes. Increased research support and expert collaborations can push this cause further.
India’s march towards a smoke-free future requires more than public health initiatives. It demands political courage, policy-driven research, and strong, decisive action. The meeting point of smoking cessation and harm reduction strategies bears immense promise in creating a healthier tomorrow not just for India, but the world.
The pioneering approaches of countries like the United Kingdom, as well as the cautious steps taken by the United State FDA, demonstrate the global recognition of harm reduction’s potential. Japan’s bold move towards legalising heat-not-burn devices serves as an inspiring example of the positive impact these strategies can have on smoking rates and related diseases.
As India embarks on the journey towards a smoke-free future, it isn’t just the world that watches. It is every Indian hoping for a healthier tomorrow – a destination with fewer smoking-related diseases and improved cardiovascular health – all achieved through effective government involvement.
Views expressed by PROF. R ZIMLICHMAN, Director – Brunner Institute for Cardiovascular Research, Sackler Faculty of Medicine, Tel-Aviv University, Member of the Board of Directors, The Israeli Society for Prevention of Acute Myocardial, Infarction, Ministry of Health, Israel
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