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Over the last 10 years, the prevalence of smoking in Indonesia has significantly increased. From 60.3 million active smokers in 2011, it rose to 69.1 million in 2021. As a result, alternative products emerged, considered to be lower risk, as a means for smokers to quit conventional cigarettes.

One of these alternative cigarette substitutes is Heated Tobacco Products, which have a lower health risk compared to tobacco cigarettes. This is evidenced by the results of a scientific literature review from the School of Pharmacy, Bandung Institute of Technology (SF-ITB) titled "Risk Assessment of Tobacco Heated System (THS) Products Based on Data and Literature Review."

Rahmana Emran Kartasasmita, a member of the SF-ITB review team, explained that various government efforts have been made, but the smoking prevalence rate has not decreased. With the development of technology and innovation supported by numerous studies, various alternative tobacco products have been created, such as heated tobacco products, e-cigarettes, snus, and nicotine pouches, as a means for smokers to quit.

"Alternative tobacco products are still a new phenomenon in Indonesia, and scientific literature reviews and domestic scientific studies on these products are still limited, thus not providing comprehensive information to the public, especially adult smokers. Based on these considerations, SF-ITB conducted an in-depth and comprehensive scientific literature review to study the risk profile and potential benefits for adult smokers," said Prof. Emran.

Emran revealed that SF-ITB conducted a risk-based scientific literature review of heated tobacco products. The review process was based on standard methods for calculating estimated risk levels available globally and referenced institutions such as WHO (World Health Organization), IARC (International Agency for Research on Cancer), and US-EPA (United State Environmental Protection Agency).

In the risk assessment process carried out by the SF-ITB team, Emran mentioned several stages: independent literature searches and scientific publications to find qualitative and quantitative data related to compounds contained in heated tobacco products and conventional cigarettes for comparison, as well as the classification of carcinogen levels referring to IARC.

Then, after the data was obtained, the SF-ITB team searched for hazard characterization data for compounds with threshold values (non-carcinogenic and non-genotoxic carcinogenic) and without safety threshold values (genotoxic carcinogenic), calculated exposure assessments with worst-case scenarios, and then proceeded with non-carcinogenic and carcinogenic substance risk characterization.

Based on the SF-ITB study results, Emran said that heated tobacco products are not one hundred percent risk-free. However, the health risk profile of these products is lower than that of cigarettes.

"The use of alternative tobacco products should be supported for adult smokers who wish to switch from their habit. Now, alternative tobacco products are available that have been shown to have lower exposure to harmful and potentially harmful constituents (HPHC) than cigarettes," said Emran.

The study results are also consistent with findings concluding that heated tobacco products and e-cigarettes have significantly lower health risks than cigarettes, based on research conducted by global health institutions such as Public Health England and the German Federal Institute for Risk Assessment (BfR).

With numerous studies conducted by various parties, Emran invited the government and relevant stakeholders to participate in reviewing alternative tobacco products together with researchers, academics, industry players, associations, and consumers.

From these research findings, Emran is confident that it will strengthen the evidence and facts about alternative tobacco products, thus providing reliable information and solutions to the public.

"Scientific studies conducted by the government and other stakeholders are eagerly awaited by industry players, associations, consumers, and academics because there is still a lot of confusing information about alternative tobacco products in the public. The results of this scientific study will later become comprehensive information for the public, especially adult smokers, to reduce smoking prevalence and thus improve public health," Emran concluded.

Source: Kontan ID