Milan has implemented a citywide smoking ban across all public spaces to combat pollution, but with a notable distinction – it exempts smoke-free alternatives like vapes. This approach reflects a pragmatic shift in tobacco control, addressing harm reduction without forcing smokers to quit nicotine, the primary reason why people smoke. For Pakistan, where smoking prevalence and urban pollution are critical challenges, Milan’s strategy offers valuable insights.

Pakistan, home to over 31 million smokers, has yet to see meaningful progress from its stringent anti-smoking measures. Beyond health concerns, smoking significantly contributes to environmental pollution. In Milan, studies show that smoking accounts for 7% of all emissions, emphasizing its impact on air quality. This is particularly relevant for Pakistan’s heavily polluted cities, where improving air quality is a pressing concern. However, an outright public smoking ban without providing better alternatives could push smokers toward unregulated markets, further complicating tobacco control efforts. 

The solution lies in embracing Tobacco Harm Reduction (THR), which promotes smoke-free alternatives like vapes, Heated Tobacco Products (HTPs), and oral nicotine pouches. These options meet nicotine needs without the harmful byproducts of smoking, offering smokers a practical choice.

Milan’s example demonstrates the effectiveness of combining regulation with harm reduction. By providing a pathway for smokers to switch to THR alternatives, the city aims to address both public health and environmental concerns. Pakistan can adopt a similar approach by integrating tobacco harm reduction into its policies. This includes creating a supportive regulatory framework, raising awareness about smoke-free alternatives, and combating illicit trade.

Khalil Iqbal