Reframing Societal Views on Harm reduction: A Medical and Scientific perspective

The Economic Times’s India’s leading media held the third edition of its Consumer Freedom Conclave, an interactive thought leadership platform driving discussion and debate around scientific methods of harm reduction covering policies and practices seeking to protect public health and reduce social harms of people and communities. Based on the theme ‘Reframing Societal Views in Harm reduction: A medical and scientific perspective’, the summit saw participation from regulatory voices, policymakers, academia, scientific and medical experts, legal, think tanks, consumer organisations, and eminent young opinion leaders who shared their perspective of consumer freedom with regarding advancements in medical and behavioural sciences and need to adopt to new age technologies backed by science.

The event brought to the fore the need for India to consider harm reduction policies and practices to protect public health and reduce problematic consequences caused by addictions and behavioural disorders. Harm reduction is an alternative strategy for the smoker who cannot, or will not, quit. A multidisciplinary approach to harm reduction often includes pharmacological, psychological, and environmental interventions that are designed to reduce risky behaviours and their consequences. Researchers have found that abstinence may not be a realistic goal for people who engage in addictive behaviours and that many consumers require moderation goals, even after completing abstinence-based treatment programs. The science around tobacco harm reduction is evolving. and now public health policies and cessation strategies should stay abreast with these advancements.

Delivering the opening address, Clive Bates, Director, The Counterfactual, United Kingdom said, Smoking prematurely kills around 8 million annually more than obesity, alcohol, road accidents, drug misuse, and HIV combined similar to impact caused by Covid 19 but every year. Most of the deaths associated with smoking is now emerging from Asia. Today, India has the second largest number of smokers in the world, however, has relatively low smoking relevance as most of the tobacco usage comprises of smokeless tobaccos. There is significant research which indicates that smokers should be encouraged to switch to vaping/reduced risk products/ safer alternatives which are at least 95% less harmful combustible smoking. Despite these benefits, the tobacco harm reduction suffers perception challenges without realising the scientific gains of these categories.”

Supratim Chakraborty, Partner, Khaitan & Co (Corporate/Commercial, Tech/Data Protection) said “When alternate products start becoming popular without getting regulated, it is then that our regulators start looking at them and think of regulating them. Economic regulation, societal regulation, administrative regulation should be the government’s important focus while making policies and none should overshadow each other.

In a fireside chat, Prof Bejon Misra, International Consumer Policy Expert and Honorary Professor at the National Law University Odisha stated “Whenever we make any law it should not be biased, but in the interest of all stakeholders. Often laws are made in haste without scientific research or without credible information. Policymaking has to be neutral, reflecting the spirit of the Constitution and it should not infringe on the laws of the consumers”.

Prof Dr. Nimesh G Desai, Senior Consultant in Psychiatry, and former Director IHBASstates “Be it at policy, healthcare or individual level, harm reduction approach has to always step in. The consumer rights movement make it obligatory to make all choices available. Multiple peer-reviewed controlled trial publications show harm reduction to be effective for a variety of clients and disorders without iatrogenic effects.” 

In our country, there is an odd adherence to and affection for products that are banned, even though they can be legally manufactured and traded. We, as consumers believe that bans on products and product-related services should only be placed if there is a substantial risk that they may cause serious injury, illness, or death. 

Kiran Melkote, Orthopaedic surgeon based in Delhi, India, and member of AHRER -Association for Harm Reduction, Education and Researchshares,Choice is the largest risk. Bans don’t work. They just disappear from the public view but are always a thriving underground market. Misinformation is being passed out, which causes low awareness amongst public. People who consume tobacco should be given a chance to quit, but if they aren’t able to then they should be given harm reducing products.”                 

“All countries are now working to harmonise laws to promote Universal Quality and Safety Standards in the interest of public health. Bans when imposed do little to protect consumers; instead they just accelerate the growth of contraband. Every banned product has a customer and an outlet, he further added.

Prof. Dr. Rohan Savio Sequeira, Consultant Cardio-Metabolic Physician, Specialist in Non-Invasive Cardiology, Diabetes, Endocrinology and Obesity Management, Hon. Consultant Physician to the Governor of Maharashtra, Senior Consultant Physician at Jaslok Hospital, St Elizabeth Hospital, S.L. Raheja Hospital, and Holy Family Hospital put mentioned that “Harm reduction is a strategy and not a view that exists; it is directed towards individuals or groups that aim to reduce the harm associated with certain behaviours. Addiction is due to the dopamine in the minds of the consumers which can’t be removed completely due to the different life patterns but surely can be reduced, which in turn fulfills the motive of harm reduction. Areas in need of harm reduction are alcohol, smoking, high sugar, drugs and tobacco products. Scientific based harm reduction is the best way to reduce long term compliance and adaption across individuals, community and institutional.”