The International Commission to Reignite the Fight Against Smoking has called for developing private-public partnerships in selected low to middle income countries (LMICs) to improve access, affordability, and local acceptability for cessation and Tobacco Harm Reduction (THR) products.

In a report on Reignite the Fight Against Smoking, the commission said with an estimated 1.14 billion people still using tobacco, the fight to create a world without smoking has stalled. “Tobacco kills nearly 8 million people and eliminates nearly 200 million disability-adjusted life years annually. The cost to the world is nearly $2 trillion dollars a year – roughly 2% of gross domestic product. The need to reignite the fight against smoking is clear and urgent,” the report said.

It recommended quantifying the size of the financial gap and the funding mechanisms to implement effective tobacco cessation and harm reduction in LMICs. “The persistence of smoking in many LMICs and by vulnerable groups in higher-income countries is evidence that previous efforts at tobacco cessation have been ineffective or stalled, or both. The report calls for multi-national, multi-disciplinary and participatory foresight studies, especially in LMICs, to identify optimal policy responses needed to end smoking and its health impacts, the impact of technological innovations and how these innovations may reshape the landscape over the next 20 years.

It maintained that evidence clearly shows that tobacco harm reduction products are substantially safer than combustible cigarettes, and the products have been proven to be effective aids to help persistent adult smokers quit. “Expand access to tobacco harm reduction products in LMICs. Because these products can be expensive, THR patents must be shared by their owners with companies that have weaker R&D capacity but can manufacture products locally.”

Calling for expanding access to tobacco harm reduction products in LMICs, the report said as these products can be expensive, THR patents must be shared by their owners with companies that have weaker R&D capacity but can manufacture products locally.

It also wants to increase the role of physicians in getting people to stop smoking. “It is time for physicians to take the lead once again with new THR technologies added to their repertoire.” The report called for encouraging medical bodies such as the Royal College of Physicians and the World Medical Association to re-establish the leadership role of doctors in ending smoking in LMICs.

The report said young people smoke at a far lower rate than adults, and youth smoking prevalence is declining in high-income countries. “Still, too many teenagers continue to smoke cigarettes, especially in LMICs, where both national governments and international organizations have not effectively addressed smoking among youth. The increased use of alternative nicotine-delivery systems raises concerns as well.”

It supported developing a global multi-company alliance that endorses and commits to enforce a common set of the highest voluntary standards, which include responsible marketing practices to restrict combustible tobacco and THR product access to those under the of age 21. The commission also advocated for governments to mandate the use of technologies to verify the age of prospective purchasers of cigarettes and THR products at the point of sale and online.