Grassroots Movements: How Local Organizations are Leading the Fight Against Tobacco Harm
The negative impact of combustion tobacco use is well documented, with millions of lives lost globally each year. According to Global Action to End Smoking, tobacco was responsible for an estimated 5,400 deaths in Malawi in 2021, which is about 7.4% of total deaths.
The report goes on to highlight that of the tobacco-related deaths in the country, 4,500 accounting for 82.7% were from direct smokers themselves, while over 979 or 18.1% were due to second-hand smoke. The World Health Organization WHO also indicates that worldwide, more than 8 million people die from tobacco use every year.
While international efforts to combat tobacco harm are cardinal, efforts by local organizations are crucial as they promote community ownership of programs and enhance the outcomes of such initiatives. Local organisations can lead the charge against tobacco harm as they understand the communities and cultures better.
Sahan Lungu, Communications lead for Tobacco Harm Reduction Malawi, shared his inspiring journey and dedication to promoting tobacco harm reduction in Malawi. Recognizing the devastating impact of tobacco use on public health, Mr Lungu champions tobacco harm reduction through the organization, as a means to reduce the burden of non-communicable diseases caused by smoking.
“I recognised the significant negative impact of cigarette smoking on Malawi’s public health system,” he says adding, “this realisation motivated me to champion tobacco harm reduction as a means to reduce the burden of non-communicable diseases caused by smoking.”
Mr Lungu explains that his passion for tobacco harm reduction was further fuelled by his work in disseminating information about safer nicotine products, research, and documentaries that taught him about the strategy of harm reduction and its potential benefits. The projects he has done highlight the need for more education on safer nicotine products among smokers, health professionals, other stakeholders and the general public.
This work is helping to fill the information gap and ensure communities as well as the general public are aware that there are indeed safer alternatives for tobacco use, other than smoking cigarettes.
For Mr Lungu, community participation in tobacco harm reduction initiatives is crucial for several reasons. Enhanced awareness and education is achieved through localized knowledge because communities can tailor messages to fit local contexts, making the information more relatable and understandable.
“Peer influence also plays a significant role, as people are more likely to trust information shared by their peers and community leaders. Increased acceptance and trust come from ensuring that tobacco harm reduction strategies are culturally and socially relevant and respectful, leading to greater community acceptance and trust in the benefits of non-combustible nicotine products, he says and continues, “community involvement aids in effective implementation by mobilising local resources and support, while grassroots advocacy helps influence local policies and practices, fostering sustainable change by encouraging ownership and empowerment.”
Most importantly, Mr Lungu believes communities can address socio-economic factors by finding alternative livelihoods for those dependent on tobacco farming, reducing resistance to tobacco harm reduction and creating support networks for individuals trying to quit smoking or switch to safer alternatives.
He says youth engagement is also key as it ensures that young people are involved in peer education to prevent smoking uptake and promote healthier alternatives while empowering future leaders to continue with tobacco harm reduction efforts.
Therefore by engaging communities in harm reduction initiatives, Mr Lungu is making these efforts more inclusive, effective, and sustainable, ultimately leading to better health outcomes.
For Public Health Specialist Alexander Thomas Mboma, initiatives that encourage community participation in tobacco harm reduction are key because they target the actual place where the smoking takes place. As a public health specialist, his involvement in tobacco harm reduction has mainly been from a scientific point of view and he has contributed towards building capacity on harm reduction and smoke cessation among mental health workers in Malawi through training.
Mr Mboma is currently conducting a study funded by Global Action to End Smoking, which is aimed at developing and testing the effectiveness of different training models on tobacco harm reduction and smoke cessation among frontline healthcare providers in Malawi. “The aim of this study is to identify the most effective training model for frontline health care providers on tobacco harm reduction and smoke cessation, that can be scaled up in other low resource settings,” he explains.
Mr Mboma says this is against the background that nurses, clinicians, and community health workers are the ones who are first-line responders when it comes to primary health care.
“So this cadre have direct access to individuals that smoke and or are willing to quit smoking or switch to safer alternatives, he says.
He says such a program is important in championing community participation in tobacco harm reduction. This is because evidence already shows that a majority of these professionals do not have training or knowledge regarding tobacco harm reduction and smoke cessation, despite their line of duty forcing them to interact with people experiencing conditions that can be directly linked to smoking tobacco.
“My interest is to ensure that this cadre is well trained and upskilled to provide tobacco harm reduction and smoke cessation services to clients who seek them,” he adds.
For World Vision Malawi, strengthening communities, advocating for improved policies and advancing research is key for tobacco growing communities to benefit from agriculture, and ensure health, education and safe working environments devoid of child labour.
In contributing to reducing the harms that come with tobacco growing, World Vision Malawi has been implementing related programs in tobacco growing districts that include Kasungu, Dowa, Ntchisi, Mchinji and Lilongwe in a campaign to get children away from child labour in tobacco growing processes.
World Vision Malawi Advocacy and Communications Director Charles Gwengwe says among the programs in the campaign are activities that raise awareness, open doors through education as well as alleviating poverty.
Mr Gwengwe says under the alleviating poverty program, children have been withdrawn from labour in tobacco production to protect them from the harms that come with handling the substance and ensure they are enrolled into school. Over 15,000 children have benefited from school feeding programs to ensure there is no excuse to work in tobacco farms.
“Young people also gained access to vocational training on agriculture practices and farm business management. The campaign through area programmes constructed classroom blocks and renovated others, and people were supported and trained to form Village Savings and Loan Associations (VSLAs), which gave them an opportunity to access credits and loans in areas where no financial institution is present,” said Mr Gwengwe.
Mr Gwengwe explains that World Vision Malawi partners with governments, businesses, community and faith-based organisations and other non-governmental organisations to allow this work to happen.
Community engagement in tobacco harm reduction remains key to increasing accessibility and acceptability of services while improving trust and credibility among community members. It will also lead to better understanding of community needs and concerns regarding tobacco harm reduction.
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