Ask a smoker if they know that their habit has a high chance of killing them and the answer is invariably, yes. It is, after all, a fact written in large letters on every legal pack of cigarettes.
Ask that same smoker to explain exactly how those cigarettes prove so deadly and the answer will get significantly vaguer.
That may seem a strange state of affairs considering how much time, effort and money has been spent trying – quite rightly – to persuade Kenya’s 2.5 million smokers to quit their habit.
But it may explain why we’re failing so miserably in this mission. And, I believe, it also holds the key to how we can reduce the 8,100 Kenyan lives lost to smoking every year, as well as prevent the suffering of thousands more with tobacco-related diseases.
I am not a medical doctor but I have had access to enough science to know the following:
In short, it’s the burning of tobacco that kills. Burning releases more than 7,000 toxic chemicals. And inhaling those chemicals can lead to cancer, cardiovascular disease and respiratory conditions.
Yet most smokers use cigarettes for the nicotine, which doesn’t cause any serious illness.
Ideally we’d convince smokers to give up completely. But we’ve learnt from experience how nigh on impossible that is.
Surely the key to saving lives is to educate smokers about the specific danger of combustible cigarettes and to persuade them to consume their nicotine in a safer form.
This is the concept of tobacco harm reduction, which seeks to cut cigarettes’ toll by encouraging adult smokers who would otherwise continue smoking to switch to scientifically proven reduced-risk products, such as vapes or nicotine pouches, gums and lozenges.
Unfortunately, in Kenya there seems to be a determination to block access to these safer alternatives. Massive taxes are levied on vapes, which put them beyond the reach of most smokers. Nicotine pouches were removed from the market last year. Some activists are even urging total prohibitions and disseminating falsehoods on the risks of the products.
Such an approach directly contradicts the results of a study by the International Tobacco Council, published in conjunction with the Ministry of Health in May, which advocates the use of nicotine products to reduce smoking rates.
The report says: “Only 16% of smokers and 13% of smokeless users plan to quit in the next month or next six months. These findings demonstrate the need to enhance access to physicians and other affordable cessation services and treatments for Kenyan tobacco users, such as Nicotine Replacement Therapies (NRTs) and quitline services.”
Nicotine itself is not totally risk-free but it has been widely sold in medicinal form as NRT for many years.
Unfortunately, there is poor awareness of these risks not just in Kenya but across the continent. For example, a study published by the Commission to Reignite the Fight Against Smoking last month found that two-thirds of South African incorrectly believed that that vaping was equally or more harmful than cigarettes and 80 per cent wrongly believed nicotine and vaping caused lung cancer.
Vapes and nicotine pouches are innovative products that present nicotine in more appealing ways and thereby help smokers in their quitting journey.
Around the world they have been proving their value as cessation tools.
Sweden has the highest consumption of nicotine pouches, but the lowest smoking and tobacco-related disease rates in Europe. In the UK, where a progressive approach has been taken by government to nicotine products, smoking rates have been slashed.
And in the US, the Food & Drug Administration this month confirmed three brands of e-cigarettes as appropriate for protection of public health and granted them marketing authorisations.
Meanwhile in Kenya, relatively risk-free vapes and pouches are regulated just as severely as far more lethal cigarettes. This effectively tells consumers that each of these products is equally dangerous and it removes any incentive to switch to the product that is, in fact, far less harmful. Thereby lives are lost.
Because nicotine is so closely associated with smoking, it’s understandable that some people think it is responsible for the harmful effects of smoking.
However, regulatory agencies who know better inadvertently perpetuate that falsehood by inaction, ignorance of scientific innovation and normalising loss of lives secondary to harmful effects of continued smoking considering the high stakes involved, that is downright irresponsible.
It has become a matter of urgency that proper awareness of life-saving tobacco harm reduction policies and products is enhanced for all.
Executive Dean, Strathmore University Business School
