Doctors in Moldova could be banned from discussing alternatives to tobacco under anti-smoking legislation

16.10.2024

Article published on the infotag.md website

The Moldovan Ministry of Health has proposed new amendments to existing anti-smoking legislation.

The authorities want to ban the introduction of new smokeless products such as nicotine pads, tighten the ban on smoking in public places and prohibit doctors from discussing different smoke-free alternatives with their patients. While some experts believe such measures would infringe the rights of patients to have access to reliable information, Grigore Novak, the Chair of Moldova’s Human Rights Commission, argues that smokers can already find relevant material on the internet.

The new amendments to the Tobacco Control Act are aimed at reducing the number of smokers and aligning local legislation with EU Directives. However, experts are against this, arguing that European regulations do not include provisions that prohibit doctors from talking to patients about alternatives to smoking.

“Moldova should, of course, implement European directives but not “run ahead of the steam engine” and create new precedents that are not covered under European legislation”, said Roman Chirca, Director of the Market Economy Institute.

Chirca admitted that he was a heavy smoker himself and had switched to electronic nicotine delivery systems, with the intention of giving up completely in future. “For people who smoke two or three packets of cigarettes a day, smokeless alternatives would significantly reduce the adverse impacts on their health and body. Doctors should only use information for this narrow group of smokers as part of a general strategy for reducing the harmful effects of tobacco products”, he said.

On the other hand, Grigore Novak argues that smokers can always find relevant information on the internet to help them decide for themselves whether they wish to switch to smoke-free alternatives.

“No doctor can advise you or me on using tobacco, either in the usual way, or by saying “switch to these products”. As a rule, a physician will try and persuade you to stop smoking altogether, rather than recommend a particular smokeless alternative. In my opinion, this will have little impact on general awareness, especially as we are living in an age when people can obtain all sorts of information from the internet. If a consumer decides to switch from traditional cigarettes to alternatives/devices, they can always find material on the web”, said Novak.

Meanwhile, doctors say it is their duty to discuss the availability of low-nicotine aerosol products with patients who smoke and have neither the desire or motivation to stop, or have already tried unsuccessfully to quit (and there about 94% of them according to WHO figures).

“Doctors are the only professionals who are qualified to discuss with patients the harm caused by a particular product, the potential benefits from switching to smokeless alternatives, or to avoid them altogether. If physicians are not allowed to do this, then who is? Bloggers with no specialist education or “armchair” experts?”. That would be absurd! Doctors should always engage with patients, not encouraging bad habits but by offering sound health advice”, said Konstantin Buchatsky, a neurologist and director of the Neurokos Centre for Neurology and Neurorehabilitation.

Novak has attributed the rise in the number of smokers in Moldova to poor implementation of existing laws. “For example, smoking in public places is prohibited, yet people continue to do so on terraces and in the street because it is not properly regulated. In fact, many are unaware that such legislation exists. But ignorance of the law does not absolve them of responsibility for their actions”, said the official.

According to the WHO’s latest report, Moldova is the only European country among six world states (the others being Congo, Egypt, Indonesia, Jordan and Oman) where tobacco consumption is continuing to rise. In 2020, the incidence of smoking was 25.8%, with the figure expected to go up by more than 2% in the next ten years.

Source: https://www.infotag.md/m9_populis/319527/