Background
Harm reduction can be described as a strategy toward individuals or groups that aims to reduce the harms associated with certain behaviors. Harm reduction is an approach that aims to reduce the negative impact of risky human behaviors and activities, without having to try to eliminate these behaviors completely. This is an important concept in public health policy, especially if a complete cessation is difficult to do.
Harm reduction is not equivalent to or better than stopping the original behavior, as it does not eliminate risk of harm, but it is better than continuing the original behavior.
Harm reduction has been applied in various aspects of daily life, such as safety, environment, physical/mental health, food and others. This concept has also been adopted in policies to reduce risks and dangers for users and the surrounding environment. Some examples of the application of the concept of hazard reduction are the use of seat belts while driving and helmets when riding motorcycles, innovations in electric cars, substitution of single-use plastic bags and packaging with environmentally friendly alternatives that can be used repeatedly, and environmentally friendly lifestyles to prevent the climate crisis.
Harm reduction in public health
Harm reduction is a public health strategy that was developed initially for adults with substance abuse problems for whom abstinence was not feasible. Harm reduction has evolved over time, from its initial identification in the 1980s, as an alternative to abstinence-only focused interventions for adults with substance abuse disorders. At the time, it was recognized that abstinence was not a realistic goal for those with addictions. In addition, those individuals who were interested in reducing, but not eliminating, their use were excluded from programs that required abstinence.
In the field of public health, the concept of harm reduction has also been applied to reduce the risk of smoking, which has been a major health problem for the past few decades. Health experts agree that there is an urgent need to reduce the negative impact of smoking on health.
Today, scientifically substantiated better alternatives to smoking exist that do not burn tobacco. As a result, they emit fewer and lower levels of harmful and potentially harmful constituents compared to the smoke produced when tobacco is burned. While not risk-free, they are much better choice than cigarettes for adults who would otherwise continue to smoke. Today’s technological developments also offer a variety of other alternative tobacco products that can effectively reduce the harm of smoking, including heated tobacco products, e-cigarettes or vapes, snus and others.
As with most innovations and new technologies, the government as a regulator needs to be adaptive to the development of innovation and technology and adapt to its use in order to make targeted and solution-oriented policies.
Asia Pacific Harm Reduction Forum 2024: Key take aways
The forum took place at the Jakarta Convention Center on July 3, 2024, and was attended by health practitioners, policymakers, academics and consumers in Asia Pacific.
The discussion was conducted in the form of a panel by discussing various research and scientific studies on harm reduction approaches, various real-world examples and benefits of their application in relevant sectors, including public health, and their application in the scope of policy.
The concept of harm reduction, especially related to smoking, has become a major topic that is often discussed among health practitioners in Asia Pacific and Globally today. Currently, there is a shared interest among Asia-Pacific countries to gain a better understanding and provide a lower-risk alternative for smokers who find it difficult to quit smoking.
All panelists recognized the importance of support from regulators and experts across the Asia Pacific region to increase understanding of tobacco harm reduction, by utilizing the use of alternative tobacco products as one of the efforts to address the dangers of smoking.
The findings suggested that alternative tobacco and nicotine products have a potential role in assisting smoking reduction and cessation, highlighting their role in the tobacco harm reduction approach. Further study should focus on investigating long-term outcomes, safety, and effectiveness of alternative tobacco and nicotine products to better inform smoking reduction/cessation policy. Long-term health impacts, especially on men’s reproductive health, lung/respiratory health, cardiovascular diseases, cancer are required further studies, to obtain clinical evidences.
The role of alternative tobacco products in public health, potential for harm reduction: while not risk-free, alternative products might offer a harm reduction strategy compared to combustible cigarettes, especially for those who find quitting very difficult.
Public health efforts should focus on: education about the risks and benefits of both traditional and alternative tobacco products, promoting complete tobacco cessation as the optimal choice and supporting those seeking to quit all tobacco products.
Indonesia is one of the largest consumers and producers of cigarettes in the world. However, at this time systematic research related to tobacco
products and their derivatives is still not widely carried out in Indonesia and is still not proportional to the condition of Indonesia both in terms of producers and consumers. Information sources from research results that conducted outside Indonesia are not always applicable to Indonesian conditions. Scientific data-based research by paying attention to data traceability and measurement is an important platform for decision-making in the preparation of regulations/rules.
