Al Zahra Private Hospital, Dubai, UAE
- Following the Quit Like Sweden event recently held in Dubai, what additional measures and positive learnings can be drawn from the Swedish example according to you?
Dr. Katranji: It was a privilege to participate in the Quit Like Sweden session in Dubai and contribute to an important discussion on how evidence-based approaches can help reduce smoking rates and improve public health. The exchange brought together diverse perspectives on cessation, harm reduction and the need to respond to the realities of adults who continue to smoke. The UAE has already taken important steps in tobacco control, including taxation, public awareness campaigns and support for smoking cessation through healthcare professionals. Sweden’s experience, where smoking prevalence has fallen to 5.3%, shows the value of combining strong public health measures with accessible, acceptable and affordable alternatives for adults who would otherwise continue to smoke.
The Smoke Free Sweden resources[1] provide further evidence and comparative studies on this approach. The takeaway is not for the UAE to replicate Sweden’s model exactly, but to adapt the core principles to its own healthcare and regulatory context, with the ultimate goal of helping more adults move away from cigarettes and reducing the harm caused by smoke.
- Why is it important to recognize that people may need different routes and different levels of support to move away from cigarettes?
Dr. Katranji: Every person who smokes has a different history, level of dependence, motivation and personal circumstances. Some may be ready to stop immediately, while others may need another form of intervention, may it be repeated conversations, clinical support or a stepwise transition away from cigarettes. If we insist that one route must work for everyone, we risk alienating another group of people who need another form of help. A more human approach starts by listening, understanding what has and has not worked before, and offering evidence-based support that meets the individual where they are, while continuing to work towards complete cessation.
- A central theme of the event was reducing harm caused by tobacco combustion. Why is education important in order to make informed choices at the consumer level?
Dr. Katranji: Education matters because many people do not clearly distinguish between nicotine, tobacco and the smoke created when tobacco burns. The scientific evidence shows that the primary drivers of smoking-related disease are the toxicants produced during combustion, rather than nicotine itself. Nicotine is addictive and is not risk-free, but confusing it with the products of combustion can prevent people from understanding important differences in relative risk. Clear and balanced information can help correct these misperceptions, support informed discussions with healthcare professionals and enable adults who smoke to make better-informed decisions, without suggesting that any nicotine product is harmless.
- How can clinicians support adult smokers who cannot or are not ready to quit, including by discussing potentially lower-risk alternatives, while still aiming for complete cessation?
Dr. Katranji: The starting point is open dialogue that focuses on respectful and non-judgmental conversation. Clinicians should first encourage a transition to complete cessation while recognizing that some patients may be unable or unwilling to quit. For these adults, a structured and transparent discussion around combustion, relative risk and potentially reduced-risk alternatives can support informed decision-making. Any guidance must be evidence-based, tailored to the individual and clear with the understanding that lower risk does not mean no risk. Continued follow-up is equally important, because harm reduction should complement existing cessation strategies, with the long-term goal of stopping nicotine use altogether.
- What practical next steps would you like to see to strengthen greater coordination with the healthcare systems, while ensuring a more evidence-based approach to tobacco harm reduction in the UAE?
Dr. Katranji: I would like to see stronger coordination among clinicians, public health specialists, researchers and policymakers, supported by clear and balanced communication of the evidence. Healthcare professionals need practical education and clinical guidance that build confidence in explaining nicotine, combustion and relative risk accurately and consistently. We also need clear pathways that connect adults who smoke with appropriate cessation support, alongside region-specific evidence to inform responsible decision-making and monitor outcomes. The Swedish experience illustrates how risk-proportionate approaches and informed clinical engagement can contribute to reductions in smoking prevalence. For the UAE, the priority should be to translate relevant lessons into a locally appropriate framework with patient safety, informed choice and complete cessation at its centre.
- There is still considerable confusion about nicotine and its role in smoking-related harm. In simple terms, what do people commonly misunderstand about nicotine, and why does correcting these misconceptions matter?
Dr. Katranji: In our position paper[2], my co-authors and I examined a persistent misconception: many people see nicotine as the main cause of the serious diseases linked to smoking. In simple terms, nicotine is addictive and is not risk-free, but the primary drivers of smoking-related disease are the toxicants produced when tobacco is burned and the resulting smoke is inhaled. Correcting this misconception does not mean presenting nicotine as harmless. Historical biases can also shape how nicotine and tobacco products are perceived, potentially hindering the objective evaluation of less harmful alternatives. It means enabling clearer, evidence-based conversations about cessation, relative risk and moving away from combustible nicotine products.
References:
- Smoke Free Sweden-UAE case study: Tale Of Two Nations – Vol. 16: United Arab Emirates vs Sweden – Smoke Free Sweden
- Further details and the supporting discussion are available in the Position Paper on Nicotine Misperceptions and Tobacco Harm Reduction: https://zenodo.org/records/20379100
