Bangladesh is at a crossroads in its fight against tobacco. Despite decades of tobacco control policies, the country still faces some of the highest smoking and smokeless tobacco use rates in the world. More than 35 million adults consume tobacco in some form, and the toll on public health is devastating: over 161,000 people die annually from tobacco-related diseases, making tobacco one of Bangladesh’s most urgent health challenges.
The Scale of the Problem
Bangladesh has one of the largest smoking populations globally, with cigarettes and bidis widely available and cheap. Beyond smoking, smokeless tobacco, including zarda, gul, and khaini, is entrenched in cultural and social practices, particularly among women and rural communities. This dual burden of smoking and smokeless tobacco use magnifies the health crisis, driving high rates of cancer, cardiovascular disease, and respiratory illness.
The government has committed to making Bangladesh tobacco-free by 2040, aligning with the World Health Organization’s global targets. However, current strategies have largely relied on traditional measures: raising taxes, imposing bans, and running awareness campaigns. While these steps are important, the persistently high prevalence shows they are not enough.
Missing Piece: Harm Reduction
What is absent from Bangladesh’s approach is a harm reduction strategy. Evidence from countries like Sweden demonstrates that providing smokers with access to safer nicotine alternatives, such as oral nicotine pouches, e-cigarettes, and heated tobacco products, can dramatically reduce smoking rates. Sweden’s experience with snus and nicotine pouches has already brought its smoking prevalence below 5%, a milestone the World Health Organization defines as “smoke-free.”
For Bangladesh, where millions of smokers struggle to quit and smokeless tobacco is deeply embedded, safer alternatives could provide a more realistic path to reducing harm. Without them, the risk is that bans and punitive measures only push consumers into unregulated, unsafe markets, or leave them trapped in combustible tobacco use.
The Risks of Ignoring Innovation
By focusing exclusively on prohibition and taxation, Bangladesh risks missing out on tools that could save thousands of lives each year. Blanket bans on all nicotine products treat them as equally harmful, despite clear scientific evidence that combustion is the primary driver of disease and death. This lack of proportionality not only misinforms the public but also denies adult smokers the chance to switch to lower-risk alternatives.
At the same time, illicit trade remains a concern. Without regulated alternatives, demand for tobacco products is unlikely to disappear, fueling black markets that are even harder to monitor and control. A pragmatic harm reduction approach, grounded in regulation, quality control, and age restrictions, would be far more effective.
GINN’s Perspective
At GINN, we believe Bangladesh must broaden its tobacco control strategy to include harm reduction alongside prevention and cessation. Policies should distinguish between high-risk products like cigarettes and lower-risk, non-combustible nicotine products. By creating a regulatory framework that ensures safety, protects youth, and provides adult smokers with genuine alternatives, Bangladesh could significantly accelerate its journey toward a tobacco-free future.
Nicotine is addictive, but combustion is deadly. Denying safer alternatives ignores global evidence and risks prolonging one of the world’s most serious tobacco epidemics. Bangladesh has the opportunity to lead in South Asia by adopting a comprehensive harm reduction model that recognizes the lived realities of its people while saving lives.
