Tobacco Asia

Tobacco Asia 27 Figure 1: Percentage of current smokeless tobacco users among adults in Southeast Asia region. Source: K Siddiqi, S Husain, A Vidyasagaran, A Readshaw, MP Mishu, A. Sheikh; Global burden of disease due to smokeless tobacco consumption in adults: an updated analysis of data from 127 countries; BMC Med, 18 (2020) cies, and campaigns instead of tobacco is problematic, because in the Southeast Asian region smokeless tobacco is more common than smoking, and as a result policies are not addressing the drivers for its use and how it is produced and sold." The researchers say smokeless tobacco, such as snus, is not a harm reduction product in SEAR, unlike in high-income countries such as Sweden and the US where smoking is the most prevalent form of tobacco use and snus is advocated as a reduced-risk alternative to combustible cigarettes. Compared to the low-cost smokeless tobacco products used in SEAR, snus poses reduced risk of disease. On the other hand, SEAR nations, where 85% of the world's smokeless to- bacco users live, have substantially greater relative risks and population attributable fractions. Therefore, Siddiqi et al argue that promoting smokeless tobacco prod- ucts as harm reduction tools in SEAR countries runs the danger of undermin- ing ongoing tobacco control initiatives in those countries, where smokeless to- bacco use is far more common and re- lated health risks are much higher than in Sweden and the US. Furthermore, the researchers point out, most reports on the health effects of tobacco up until re- cently were largely based on studies from high-income studies and usually did not highlight what the researchers call tobac- co-induced conditions that are relatively uncommon in high-income countries, such as tuberculosis. Instead, the reports

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