Recently, the Star newspaper published an opinion piece titled 'Academia must stop fake science in promoting tobacco products' discrediting and downplaying independent research by Kenyan researchers.
I'm a scientist who recently together with my colleagues unveiled the first and major research comparing the risks, and toxicants, of locally used smokeless tobacco—areca nut and khat. Thus, I feel compelled to respond in defence of our scientific work and right the inaccuracies and misinformation in the article.
Scientific investigation into the chemicals produced by consumer products, whether traditional, conventional, modern or new technologies, regulated or unregulated, is essential to understand the potential risks they pose to the people who use them directly or indirectly.
Across the world, leading scientific institutions are researching tobacco products and tobacco-free nicotine products to create broad scientific consensus on their risk profile, which is critical in guiding evidence-based public health policy.
Unfortunately, in Kenya, we lag behind in research into the smokeless tobacco products and oral stimulants consumed by approximately 7.7 per cent of our population. Invaluable data barely exists on the use of smokeless tobacco, areca nut and khat.
In addition, very few studies have assessed the impact, risks and toxicants associated with nicotine replacement therapies and modern oral nicotine products.
While it may be preferable that we lived in a utopic world where these products do not exist, the reality is they do, and it is our job as researchers to interrogate their safety and identify the toxicants and risks.
We as scientists recommend viable, pragmatic and safe evidence-based remedies to the effects of consuming these products and endeavour in assisting the users to quit. To brand academics who research these products as 'pushers', 'recruiters' and proponents of pseudoscience is entirely unmerited.
As academics, we learn to embrace critical assessments of our work. However, critics choose to put science into quotation marks and use terms such as fake science or pseudoscience. This makes it seem that their only objective is to undermine and attack the research with an aim of misinforming the public and eclipsing evidence-based scientific findings.
For instance, not one piece of referenced or credible evidence was put forward in the opinion piece in question to justify claims of pseudoscience being conducted by Kenyan academics.
Instead, the argument was based on conspiracy theories and alarmist tactics to undermine all research into these products. Research is countered by research and not mere rhetoric.
By comparison, I led a team of researchers at the University of Nairobi’s Faculty of Medicine in conducting an in-depth analysis of evidence available on local oral and snuffed tobacco and other oral or snuffed stimulants. Our report was meticulously researched and referenced, citing leading global authorities on tobacco-related disease.
We found that oral nicotine products carry similar levels of toxicants and risks as nicotine replacement therapies, which feature on the WHO’s essential medicine list. According to the Royal College of Physicians oral nicotine products “differ substantially in their risk profile” compared to the toxins in tobacco.
By comparison, we found that common oral stimulants such as khat, areca nut and gutkha have little or no quality control in terms of the levels of toxicants or psychoactive ingredients. They also carry considerable health risks, including contaminants such as heroin and cocaine.
Our analysis shows that there is not enough research available on oral stimulants or nicotine products use in Kenya. This is an area where we desperately need more data. It is, therefore, irresponsible for naysayers to try to intimidate academics from doing further research.
In an ideal world, no one would chew khat or smoke cigarettes or use smokeless tobacco products or use tools to stop smoking. Still, the reality is that there are approximately 4 million people in our country who do use them.
They deserve information about their chemical profiles and viable, pragmatic and safe modalities of being helped to quit consuming those products such as that seen in methadone maintenance treatment for opioid consumers.
The scientific, activist, tobacco control and health advocates communities must continue to work together to better public health as we are ultimately aligned in our objective to reduce the harm and disease caused by the use of tobacco and other stimulants.
Harm reduction is a pragmatic humanistic approach to high-risk behaviours that focuses on mitigating the harmful consequences of such behaviour.
We cannot allow scaremongering and misinformation to obscure academic scientific research. Instead, we must remain singularly and objectively focused on providing workable solutions to our public health needs and have a broad-based policy formulation and implementation based on evidence-based science.
Medical doctor and public health specialist
