A literature review of the global tobacco harm reduction and cessation programmes targeting vulnerable populations was undertaken with the support of the Foundation for a Smoke-Free World. The review focuses on the development of a survey tool designed to assess the unique needs of the different marginalised communities in Pakistan.
Tobacco consumption and substance abuse are global challenges fuelled by several factors. One million people worldwide die every year due to second-hand smoke. Up to half of the current users will eventually die of a tobacco-related disease, with many of these users living in low and middle-income countries. In Pakistan, 14.5% of tobacco users and 11.1% of cigarette smokers are uneducated, and approximately 29 million adults in Pakistan consume some form of tobacco. In 2019, the total cost of all smoking-attributable diseases and deaths in Pakistan amounted to Rs. 615.07 billion - with the burden of this cost being heavily gendered and being incumbent on geographical location and age. As tobacco use in religious and ethnic minorities and marginalized communities is not widely researched, accurate and current data sets are not yet available. This further highlights the neglect of the needs of these communities and the lack of adequate services for them.
To bridge this gap, IDS has conducted a “Health Needs & Demands Assessment” to investigate the trends of tobacco users in marginalized and vulnerable communities of Pakistan to reduce the barriers to quitting or switching to safer nicotine delivery systems. It includes assessing the size and nature of tobacco use, availability of cessation services, perception of needs, and the effectiveness of various clinical solutions. The assessment also explores the cost implications of providing alternate and safe options for tobacco reduction.