November 20, Colombo (LNW): Sri Lanka could stand to save an estimated GBP 8.2 billion over the next three decades if it embraces a structured Tobacco Harm Reduction (THR) strategy, according to a specialist in tobacco regulation.
At current exchange rates, this projected saving amounts to roughly Rs. 3.32 trillion—funds that could significantly ease the burden on the national health system.
Dr Rohan Sequeira, Founder-Director of the Society of Medically Harm Reduced Alternatives (SOMHRA) and a well-known cardio-endocrine consultant, noted that the country currently spends around GBP 400 million each year treating illnesses linked to tobacco use.
With about 22 per cent of adults still using tobacco in some form, he warned that Sri Lanka continues to face a pressing public health challenge.
Speaking at South Asia’s inaugural “Quit Like Sweden” Anti-Tobacco Roundtable held in Colombo, Dr Sequeira highlighted Sweden’s notable success in reducing smoking-related disease through harm-reduction policies rather than outright prohibition.
The QLS initiative, which supported the event, encourages governments to adopt practical, evidence-led approaches rather than relying solely on traditional bans.
Dr Sequeira also drew attention to Sri Lanka’s high incidence of oral cancers—among the highest in South Asia—with roughly 3,000 new cases recorded each year, particularly among men. Without effective intervention, he cautioned that these numbers could double by 2044.
He argued that blanket bans on tobacco are rarely effective, often driving consumers towards illicit markets where products are unregulated and potentially more unsafe. Instead, he urged policymakers to expand regulated access to reduced-risk alternatives for adult users, while simultaneously tightening controls to ensure minors cannot obtain e-cigarettes or other nicotine devices, which are currently easy to purchase both online and in shops.
In outlining a way forward, Dr Sequeira proposed several measures, including pilot THR programmes in districts with the highest disease burden, the formation of a multi-party advisory panel on THR policy, a detailed regulatory impact assessment, and a long-term communication strategy to educate the public.
He emphasised that it is the smoke and bacterial contamination in conventional products that pose the gravest risks, not nicotine itself.
He added that Sri Lanka must design approaches suited to its own social and cultural context, as policies that prove successful overseas cannot simply be replicated without adaptation. Present tobacco use patterns in the country remain diverse, with betel quid mixed with tobacco accounting for the largest proportion at 42 per cent, followed by cigarettes (28 per cent), beedi (18 per cent), and other smokeless products (12 per cent).
