Rigidity towards Harm Reduction detrimental to smokers’ welbeing, warns advocate
“Evidence suggests that while the number of people smoking is reducing in countries that have embraced Harm Reduction, it is increasing in countries that have not, especially in Africa,” said Malawi’s Harm Reduction Advocate Chimwemwe Ngoma.
This was during the 4th Harm Reduction Exchange held on November 27, 2024, in Nairobi, Kenya, where other experts equally expressed concern about the low uptake of alternatives to combustion tobacco, continually exposing smokers to diseases such as lung cancer among other conditions.
The 4th Harm Reduction Exchange was held under the theme, ‘Enabling Innovation in Harm Reduction Through Science-Led Regulation and Policymaking.’
Mr Ngoma has warned against the rigidity of African countries that have not embraced Smokeless Nicotine Products (SNPs), as existing research has already shown that safer alternatives to combustion tobacco have helped reduce overall cigarette consumption while reducing smoking-related mortality.
Countries such as Sweden, The United Kingdom and Japan have already seen a decline in smoking rates and a reduction in related health complications, due to the availability of SNPs such as snus, nicotine pouches and oral nicotine products among others.
Snus is a type of SNP that originated in Sweden and is placed between the upper lip and gum, where it releases nicotine and flavourings.
Mr Ngoma highlighted that by embracing snus, Sweden has seen the daily smoking prevalence decline from 27% in 1981 to only 5.3% in 2022, while daily snus use increased to 20.2% from 14%.
Further, a 2019 study revealed that substituting smoking with snus reduced smoking-related deaths by 50% in Sweden alone, in comparison with other countries in the European Union (EU).
Sweden also has the lowest incidence of lung cancer incidence and mortality rate among men in the EU, and this has been attributed to the use of snus.
Currently, statistics indicate that while the combustion cigarette is available to all at a global level, safer alternatives such as nicotine vapes are legally available to only 54 % of the global adult population, Heat-Not-Burn (HTP) products to 36%, snus to 58%, and nicotine pouches to 35%, a matter that is concerning as it means more people are exposed to harmful combustion tobacco, with potential for serious consequences to their health.
HTP products are those that heat tobacco to a lower temperature than traditional combustion rather than burning it, thereby reducing the release of harmful chemicals and toxins associated with combustion smoking.
Safer alternatives to tobacco provide a lower risk of smoking-related diseases such as lung cancer and heart disease, especially for adult smokers who are unable to quit.
For Mr Ngoma, it is essential for African countries to adopt effective tobacco control policies and Harm Reduction strategies to address the growing challenge of combustion tobacco, especially because for many people, quitting is a problem and they the need assistance that comes with safer alternatives.
Many African countries have limited access to Harm Reduction alternatives such as e-cigarettes and nicotine replacement therapy, making it harder for smokers who cannot quit combustion tobacco.
Mr Ngoma said there is a need for efforts aimed at encouraging smokers to switch to smokeless nicotine products, and this can be done through subsidies and favourable taxation regulations while promoting awareness campaigns.
Mr Ngoma has challenged African countries to allow science-led principles to guide their regulation towards Harm Reduction efforts, in order to save populations from diseases related to combustion tobacco.
Mr Ngoma said there is also a need for unconventional approaches to Harm Reduction that prioritise public health above everything.
Mr Ngoma believes smokeless nicotine products can actually be a tool to help smokers quit because they provide a safer alternative sources of nicotine.
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