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STUDY PROTOCOL article

Front. Public Health
Sec. Substance Use Disorders and Behavioral Addictions
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1518069
This article is part of the Research Topic Adolescent Smoking, Alcohol Consumption and Psychoactive Substance Misuse in Low-Middle Income Countries View all articles

Literacy among Tobacco Users and Healthcare Professionals About Tobacco Harm Reduction Strategies: A Scoping Review Protocol

Provisionally accepted
Sajid Iqbal Sajid Iqbal 1*Sudhanshu Patwardhan Sudhanshu Patwardhan 2Erika Sivarajan Froelicher Erika Sivarajan Froelicher 3. Kainat Asmat . Kainat Asmat 1Rubina Barolia Rubina Barolia 4
  • 1 Faculty of Nursing and Midwifery, Shifa Tameer-e-Millat University, Islamabad, Pakistan, Islamabad, Pakistan
  • 2 Centre for Health and Edcuation-UK and South Asia, Hampshire, United Kingdom
  • 3 University of San Francisco, San Francisco, California, United States
  • 4 School of Nursing and Midwifery, Aga Khan University, Karachi, Punjab, Pakistan

The final, formatted version of the article will be published soon.

    Objective The proposed review identifies and describes the extent of Tobacco Harm Reduction (THR) strategies in Pakistan. It also examines the awareness and understanding of these strategies among healthcare professionals and tobacco users in Pakistan. Introduction Tobacco consumption poses a significant threat to human health and is a leading cause of non-communicable diseases. Over the last two decades, the prevalence of tobacco use has increased in low- and middle-income countries (LMICs), which has considerably contributed to the increasing prevalence of Non-Communicable Diseases (NCDs). Tobacco is consumed in various forms, including manufactured cigarettes, hookah/shisha, chewing tobacco, and dipping tobacco. Tobacco use can be reduced and prevented through various strategies adopted by many countries worldwide. One prominent strategy is THR. THR involves the use of safer nicotine products in recommended doses to cope with the symptoms of withdrawal and increase tobacco users' chances of quitting smoking. In Pakistan, the concept of tobacco harm reduction (THR) is not widely recognized by healthcare professionals and tobacco users. Inclusion and Exclusion Criteria Literature available on Pakistani adults and adolescents (aged 13 years and above) will be included. Literature available as free full text will be included regardless of the publication date. Furthermore, literature available in English or Urdu will be considered eligible. Also, literature available in any form of publication, such as research studies, reviews, organizational websites or blogs, will be considered eligible. Literature that includes Pakistani data mixed with data from any other country will be excluded. Methods The literature search will use PubMed, CINAHL, ProQuest Theses & Dissertations, EBSCO Dentistry and Oral Sciences, and PsycInfo databases for online and gray literature. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow diagram will record the included and excluded literature. Two independent reviewers will screen all the retrieved literature. After confirming the eligibility criteria, data from included records will be extracted on an Excel sheet that will record the important characteristics of the literature source and the main findings. Meta-synthesis of collated data will be performed, and the results will be presented as narrative summaries and frequency tables.

    Keywords: Tobacco harm reduction, Harm Reduction, Tobacco use, Harm reduction strategies, Tobacco alternatives, Nicotine, electronic cigarettes

    Received: 27 Oct 2024; Accepted: 13 Jan 2025.

    Copyright: © 2025 Iqbal, Patwardhan, Sivarajan Froelicher, Asmat and Barolia. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Sajid Iqbal, Faculty of Nursing and Midwifery, Shifa Tameer-e-Millat University, Islamabad, Pakistan, Islamabad, Pakistan

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.