Abstract
The global tobacco crisis claims between 8 million lives annually with most of the 1.3 billion tobacco smokers being from low- and middle-income countries, further emphasizing health disparities. Pakistan has a high burden of tobacco-related illnesses, and it is among the 15 countries. Nonetheless, no national survey has been conducted in Pakistan to monitor the use of tobacco among adults since 2014 to measure tobacco reduction efforts. As a response to the harm reduction demand across the country, the cross-sectional survey was carried out on 405 adult smokers within Islamabad and Rawalpindi. Data was collected using a structured and validated questionnaire. Descriptive and inferential statistical analysis was done using chi-square, Fisher's exact test, and logistic regression, respectively. The research identifies the essential variables affecting smoking cessation and adoption of THR, the importance of such demographic factors as age, education, and smoking intensity. The age factor was very significant since every extra year was combined with a 6.2% reduction of the probability of using THR (β = -0.062, 95% CI: -0.091 to -0.032, p < 0.001). Education was also positively influential in such a way that every next higher degree of education would raise the likelihood of using THR by 8.7% (β = 0.087, 95% CI: -0.013 to 0.161, p < 0.002). The employment status had a slight, but significant impact with the employed status raising the chances of using THR product usage by 43.3% (β = 0.433, 95% CI: -0.069 to 0.935, p < 0.009). The cigarette per day consumption became a significant predictor as an extra cigarette smoked raised the chances of using THR product by 6.8% (β = 0.068, 95% CI: -0.030 to 0.105, p < 0.001). Yet, one of the most significant information deficiencies between users of THR products is the reason why they often relapse into the habit of smoking once again. There is no difference in the age groups in terms of the perception of the safety of THR products, which makes it necessary to implement even more complex educational and awareness programs. Although age, education, and the intensity of smoking are all predictors of THR use and adoption, smoking duration and THR adoption showed no statistically significant correlation. On the whole, the paper is valuable in understanding the factors that will contribute to smoking cessation and adoption of harm reduction products in Pakistan.