How Tobacco Harm Reduction Can Decrease The Public Health Burden of Smoking in Laos.
The Lao People’s Democratic Republic, also known as Laos, is a country that has both a problem with its smoking prevalence and can have a potential solution through tobacco harm reduction (THR). As of 2022, Laos had an estimated adult smoking prevalence of 23.8%, which means that more than 1 in every 4 adults were smokers. This rate only increased when looking at men alone, jumping up to 43.2%, or almost half the male population. Although the smoking rate has seen a decline when compared to previous measures, there is still a long way to go.While smoking rates remain high, this also affects smoking-related disease and deaths in Laos, with 12.77% of annual deaths and 17.76% of male death attributed to smoking in 2021. Something must change – and fast.An often-suggested solution to Laos’ smoking problem is an increase in taxation on traditional cigarettes. With the second-lowest tobacco prices and the lowest tobacco tax among ASEAN countries, taxation is surely a viable avenue. In fact, Laos only charges 15% of tax on cigarettes – while the WHO recommended rate is at least 75%. However, increasing tax on cigarettes is only part of the solution. With the well documented struggle that smoking cessation brings, viable harm reduced alternatives must be in place to help smokers switch.
Unfortunately, Laos adopts an all-or-nothing approach with heavy bans on alternatives, such as vapes and HTPs, to traditional cigarettes. With a strong focus on traditional tobacco control and prohibition, Laos’ well-intentioned but misinformed actions may backfire on the very smoking rates they aim to decrease. Instead of banning alternatives, legalized and well-regulated THR products, taxed according to their risk relative to cigarettes, encourage smokers to switch, helping decrease both the smoking rate and the rate of smoking-related disease and death.
Any solution must also be tailored to the specifications of Laos’ smoking prevalence. The majority of tobacco users are men in rural areas, with easy access to cigarettes and restricted access to health information. A combination of localized training and access to economical and harm-reduced alternatives, such as oral nicotine pouches, can make all the difference.
By formally integrating a THR approach, alongside higher cigarette taxations, Laos can not only improve its public health and reduce the health burden of smoking but it can also set an example in its regional context.
