Experts Say Smoking Cessation Requires Strong Clinical and Policy Support

Summary:
Experts at the 9th Summit on Tobacco Harm Reduction said simply telling smokers to quit is not enough and called for stronger clinical support to help people overcome tobacco dependence. They also stressed that tobacco-control policies should be regularly reviewed and updated based on emerging scientific evidence, while distinguishing the health effects of nicotine from those of cigarette smoking. Discussions highlighted the need for stronger prevention, cessation services, protection of young people and non-smokers, and transparent public health communication. Experts said effective tobacco-control strategies should combine prevention, protection from exposure and accessible cessation support. 

Simply advising smokers to stop is not sufficient, and greater attention should be given to clinical treatment for tobacco dependence, experts said. They also stressed that public health policies should be regularly updated in line with emerging scientific evidence.

The experts shared these views during the 9th Summit on Tobacco Harm Reduction, conducted virtually from September 28 to 30. The event brought together clinicians, researchers and policy specialists to discuss tobacco dependence, smoking cessation, nicotine use among young people and the importance of scientific evidence in developing tobacco-control policies.

Dr Mohsin Wali, Senior Consultant in Internal Medicine at Pacific OneHealth, Delhi, and a founding member of Doctors Against Addiction (DaAD), said there was an important distinction between simply advising smokers to quit and providing them with the support needed to overcome tobacco dependence.

“Every smoker should be encouraged and supported to quit, but after more than four decades in clinical practice, I have seen that telling a smoker to quit and helping that person actually quit are two very different things,” Wali said.

He noted that many of his patients who smoke cigarettes or bidis find it difficult to stop, making it important for doctors to consider available scientific evidence when assisting them with cessation.

“No nicotine product is 100 per cent safe, but different products can carry different levels of risk,” Wali said.

He added that public health policies should be reassessed periodically as new evidence becomes available to ensure that decisions continue to be guided by scientific findings.

Neal L Benowitz, Professor Emeritus of Medicine at the University of California, San Francisco, said nicotine and cigarette smoking should be viewed separately when evaluating their health effects.

“Nicotine is not synonymous with cigarette smoking, and understanding its health effects requires us to distinguish the pharmacological effects of nicotine from the much broader harms caused by tobacco burning,” Benowitz said.

He said nicotine is addictive and that its cardiovascular effects, including impacts on heart rate, blood pressure and blood-vessel constriction, should not be overlooked.

However, he noted that the health risks associated with nicotine products are not necessarily the same as those linked to cigarette smoking, highlighting the importance of evaluating different products based on scientific evidence.

“Protecting young people from nicotine initiation must remain a priority, while for adults who already smoke, the focus should remain on helping them quit and understanding the relative risks of different nicotine-delivery products,” Benowitz said.

The India-focused sessions examined the country’s tobacco-control framework along with continuing concerns surrounding tobacco dependence, enforcement and informal markets.

Speakers called for stronger prevention and smoking-cessation services, greater protection for children and non-smokers, and public health messaging that remains transparent and grounded in reliable scientific evidence.

The discussions also considered restrictions on smoke-free nicotine alternatives. Speakers observed that such restrictions alone may not remove demand for nicotine and could result in some adult smokers continuing to use combustible tobacco or shifting towards illicit alternatives.

Experts therefore said effective tobacco-control strategies should bring together prevention, protection from tobacco exposure and stronger cessation assistance, while remaining adaptable to the quality and direction of emerging scientific evidence.