Urgency for a new approach to tobacco control in Kenya

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Tobacco use is the topmost preventable cause of death in Kenya according to the Ministry of Health. You would think that the government would be doing everything they can to reduce this impact of smoking on Kenya’s population. However, as it stands, the government continues to take a quit or die approach to tobacco control. Kenya urgently needs to shift its focus away from this and embrace a harm reduction mindset. However, we remain very far from this and it threatens hundreds if not thousands of lives.

The urgency for a new approach to tobacco control in Kenya was highlighted at a conference hosted by the Campaign for Safer Alternatives (CASA) and the African Harm Reduction Alliance (AHRA) last week. The conference coincided with the publication of a CASA survey of more than 200 Kenyans which found that more than a third of smokers who try to quit, fail to do so. It’s clear that these smokers need all the help possible to ensure that their next attempt to quit is successful. They should not be cast aside so easily.

So what can be done to reduce the harm experienced by smokers and help lift a burden from Kenyan society? As Dr Kgosi Letlape, a doctor and AHRA President noted, most of the harm caused by cigarettes is from the burning of tobacco. If smokers switch to alternative products which don’t contain tobacco, you instantaneously reduce the harm and ultimately save lives.

The conference, which was attended by over 50 delegates from across Africa and international and Kenyan medical experts, heard that the current approach of the government is not working. Despite the fact that nine out of ten smokers think nicotine pouches or vapes/e-cigarettes are the most effective quitting tool, Kenya continues to have a regulatory environment that is unsupportive of these products.

Kenya continues to treat tobacco-free nicotine products the same as more harmful tobacco products like cigarettes. As shown by the same CASA survey, this contrasts sharply with the majority of Kenyans who object to the harsh regulatory treatment of nicotine pouches or e-cigarettes/vapes.

It’s hard to fathom the reluctance of Kenyan authorities to embrace harm reduction, even though a vast swathe of international research shows that alternative nicotine products are approximately 95% less harmful than cigarettes.

Researchers in Kenya have played a key role in developing this evidence. Researchers from the Faculty of Medicine at the University of Nairobi, led by Dr Michael Kariuki, have gathered evidence that shows that tobacco-free nicotine products have a significantly lower risk for users than other traditional tobacco and oral stimulants due to the fact that they expose users to far fewer toxicants than tobacco, khat or gutka products.

Despite this, the debate in Kenya is replete with statements that exaggerate the health risks of nicotine alternatives and ignore the potential impact they could have on reducing Kenya’s smoking rates. Many of these statements amount to misinformation and they are having an effect.

10% of those surveyed by CASA think nicotine-only products have the same impact on your health as tobacco. Astonishingly, 1 in 5 think that tobacco is only slightly more harmful than nicotine-only products. This flies in the face of what we know about the risks from tobacco smoking which almost entirely derives from the burning of the tobacco and not the nicotine itself. In fact, nicotine products like patches and gums are widely embraced as tobacco cessation tools.

The COVID-19 Pandemic illustrated the importance of trusting science, accepting evidence and listening to experts. The science is clear, tobacco harm reduction saves lives and Kenya’s current anti-harm reduction policies will cost lives. Instead of adopting a dogmatic, unscientific stance against tobacco harm reduction, Kenya should be embracing it as an exciting opportunity to save thousands of lives lost to cigarettes.”

We need to take an approach that places risk reduction at its heart and move away from an all or nothing absolutist perspective. Otherwise, we will continue to see thousands of smokers persisting in a habit that will ultimately lead to their death.

Joseph Magero
Chair: Campaign for Safer Alternatives

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