KARACHI: A research project on smokeless tobacco will see collaboration among universities from Pakistan, India and Bangladesh, it emerged on Wednesday.

Titled ‘Addressing Smokeless Tobacco and Building Research Capacity in South Asia (Astra)’, the project is funded by the UK’s National Institute for Health Research.

The study will be led by Dr Kamran Siddiqui at the University of York in the UK and will be conducted in partnership with Aga Khan University (AKU) and Khyber Medical University (Pakistan), Maulana Azad Medical College (India) and the University of Dhaka (Bangladesh).

“The use of smokeless tobacco products is a major factor behind oral cancer, the second most common form of the disease in Pakistan. Recent researches have shown that smokeless tobacco can now be linked to cardiovascular diseases, a leading cause of death across the world,” said Professor Javaid Khan from AKU.

Unlike cigarettes, smokeless or chewing tobacco products such as paan (betel leaf), niswaar (powdered tobacco snuff) and gutka (a mix of tobacco and areca nut), carry no health warnings on packaging that could help people realise their life-threatening consequences.

“You can buy four packets of chewing tobacco for under a rupee from any cabin on the street and most people think that these products are harmless.

“Everyone is focused on cigarettes even though 85 per cent of the world’s 300 million users of chewing tobacco live in countries in South Asia such as Pakistan, India and Bangladesh,” Dr Khan said.

The wide scope of activities under the study range from qualitative studies into the personal and socio-economic reasons that drive smokeless tobacco use, right through to the development of cost-effective interventions that work best for each country’s policy environment.

The first step, however, is to establish a baseline scenario of the drivers of smokeless tobacco consumption, especially among the youth. “This would not only cover the motivations of consumers but would also explore the lobbies and business interests that are preventing legislation,” he said.

Insights from this phase of the study will lead to the development of cessation interventions. This phase will see researchers test whether economic incentives, behavioural change measures, or the use of medicine-based therapies, can help users quit smokeless tobacco products.

“The idea is to get a comprehensive picture of the scale of the problem before we develop feasible cost-effective policy proposals,” said Dr Romaina Iqbal, an associate professor at AKU and co-investigator of the study.

Published in Dawn, May 10th, 2018