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Policymakers in Kenya need to Understand Nicotine

Two weeks ago we hosted a workshop on tobacco harm reduction. We discussed the evidence that shows innovative nicotine alternative products, such as tobacco-free pouches and e-cigarettes, can deliver nicotine with a drastically reduced toxicant profile compared to traditional tobacco products.

The workshop was a discussion and networking platform designated to facilitate exchange of ideas among health practitioners, policy makers, academics, consumers, advocates and media from across the country. Participants got to receive K.A.C’s Tobacco harm reduction and right to Health report, which was handed to them after the event.

The workshop is timely, we are hopeful that it will spark a conversation on why Kenya has little to no available smoking cessation services, which beg the question; can the country be 100% smoke-free in our lifetime? As the rest of the world continues to reap the benefits of safer alternatives, most medical practitioners and policymakers in Kenya haven’t got the slightest idea of what the concept of tobacco harm reduction is.

Not only are alternative nicotine products effective, they are also cost-effective for the government. The state pays nothing when an adult smoker switches to alternative nicotine products. Compare this with costly state-run programs. Meanwhile, by helping smokers quit, nicotine alternative products help ease the disease burden of smoking and the associated costs to the state.

Nicotine is not carcinogenic, it does not cause cancer! You’ll be surprised to know that Nicotine doesn’t cause smoking-related diseases, such as cancers and heart disease .Cigarette smoking and the many chemicals it exposes a person to, not nicotine itself, presents the highest risk. According to Cancer research UK , nicotine is addictive but does not cause cancer. Most damage to health caused by smoking is due to tar. Researchers from U.K. National Institute for Health and Care Excellence (NICE) stated that “…it is primarily the toxins and carcinogens in tobacco smoke — not the nicotine — that cause illness and death.” In fact, other chemicals in smoke, such as benzo[a]pyrene, tobacco-specific nitrosamines, and benzene, are the primary causes of smoking-related diseases.

It’s the burning which causes the harm. Consuming nicotine without any burning is same like getting a caffeine rush from drinking hot coffee. Most research points to cigarette smoke, not nicotine, as being the primary contributor to cancer among smokers. The W.H.O understands this, so much so that they recommend nicotine patches for smokers looking to quit smoking.

Traditional measures to reduce smoking rates, such as increasing taxes, banning advertising and restricting smoking in public areas, have reduced tobacco use in Kenya by only a single percentage point in the four years to 2016.We need a change in approach.

Alternative nicotine products represent a genuine route to a smoke-free future that has been proven to work in countries that have embraced these products.

Tobacco Harm Reduction Workshop- Gelian Hotel, Kenya

30th October, 2020

We are pleased to announce that there will be a tobacco harm reduction workshop and training stream running on the 30th of October 2020 at the Gelian Hotel in Machakos county, Kenya. Media and health experts based in Kenya, will be successfully oriented into the concept of tobacco harm reduction through the workshop.

The workshop is a discussion and networking platform designated to facilitate exchange of ideas among
health practitioners, policy makers, academics, consumers, advocates and media from across the country. 

The theme for this year’s event is: Safer Alternatives: A gateway to a smoke-free Kenya. 

The workshop is timely, we are hopeful that it will will spark a conversation on why Kenya has little to no available smoking cessation services, which beg the question; can the country be 100% smoke-free in our lifetime? As the rest of the world continues to reap the benefits of safer alternatives, most medical practitioners and policymakers in Kenya haven’t got the slightest idea of what the concept of tobacco harm reduction is.

For further information on the workshop, kindly reach us at info@thrkenya.org

HARM REDUCTION CAN REDUCE SMOKING RATES IN KENYA

ONE in every three Kenyan smokers has tried to quit.

Yet, only a tiny fraction succeed.

Just how do we help them kick this deadly habit? And how do we persuade other smokers that it is a good idea to follow suit?

A sensible start would be to reject calls for tobacco-style restrictions on nicotine pouches.

Advocates for Tobacco Harm Reduction, like myself, believe that such knee-jerk reactions against innovation are dangerously counter-productive and block routes to a healthier future.

This is what Tobacco Harm Reduction is all about: getting serious about saving lives by acknowledging that the majority of the harm from cigarettes is caused by the burning of tobacco, which releases thousands of dangerous toxicants.

The evidence from countries like Sweden suggests that if smokers can get their nicotine without burning tobacco, we should be able to dramatically reduce the 30,000 tobacco-related deaths seen in Kenya every year.

Get rid of the burning, reduce the harm. Better still, get rid of the tobacco altogether.

Evidence shows that innovative nicotine alternative products, such as tobacco-free pouches and e-cigarettes, can deliver nicotine with a drastically reduced toxicant profile compared to traditional tobacco products.

A tobacco-free nicotine pouch, which is placed between the lip and the gum, would appear to be a particularly relevant alternative for smokers in Kenya, and the wider east African region, where there is a long tradition of using oral stimulants.

Such pouches do not contain any tobacco. With nicotine as the only active ingredient, they would belong on a similar risk spectrum to mainstream nicotine-replacement therapies (NRTs), such as nicotine gums, sprays, lozenges and patches.

Significantly, research shows that some alternative nicotine products are up to twice as effective as NRTs when helping smokers to quit. There are a number of theories as to why this might be, but it is likely due to the fact that, in the countries where these studies were conducted, there is (a) widespread public awareness about the relative risks of such products, (b) alternative nicotine products can typically be sold anywhere cigarettes are available: their retail is not limited to pharmacies; and (c) there is a resulting lack of stigmatisation involved with using such products.

Take Sweden, for example. Swedes have the highest consumption of pouches and the lowest smoking rates in Europe. The Swedish rate of tobacco-induced cancers for men is less than half the EU average.

Or look at the UK, where the government has adopted a progressive approach to alternative nicotine products, backed by international anti-smoking advocacy groups such as Action on Smoking and Health.

In just one year, e-cigarettes helped over 50,000 people in England quit smoking, while there are more than 6 million ex‐smokers in Europe who report that vaping helped them to end their smoking habit.

This is what makes calls for the Kenyan government to regulate tobacco-free nicotine pouches as if they were the same as cigarettes so alarming and regressive.

Other than the obvious point that these pouches are tobacco free, and therefore an ill-fit for legislation targeted at tobacco, the real issue is that this outdated approach could actually end up costing lives.

If Kenyans are told that nicotine is the same as tobacco and that nicotine pouches are the same as cigarettes, there is a serious danger they will be deterred from making the switch to less risky products.

This would be a huge setback for the Tobacco Harm Reduction movement in a region that is already making slow progress in the fight against smoking.

Another problem is that anti-smoking advocacy groups in Africa routinely suggest that alternative nicotine products pose a special danger to young people.

These claims wilfully ignore international data which consistently shows that regular use of alternative nicotine products amongst young people who have never smoked is extremely rare (typically around 0.04%) and that the majority of alternative nicotine product users are current or ex-smokers.

While nicotine pouches should never be sold or marketed to under-18s, it makes perfect sense to promote them as an alternative to adult smokers by making them available wherever cigarettes are sold and subject to the same supervision.

Not only are alternative nicotine products effective, they are also cost-effective for the government. The state pays nothing when an adult smoker switches to alternative nicotine products. Compare this with costly state-run programmes. Meanwhile, by helping smokers quit, nicotine alternative products help ease the disease burden of smoking and the associated costs to the state.

Traditional measures to reduce smoking rates, such as increasing taxes, banning advertising and restricting smoking in public areas, have reduced tobacco use in Kenya by only a single percentage point in the four years to 2016.

We need a change in approach.

Alternative nicotine products represent a genuine route to a smoke-free future that has been proven to work in countries that have embraced these products.

It is therefore essential that Kenya adopts a balanced approach to such products. We cannot simply treat them like tobacco products, when they are clearly so successful at helping smokers move away from tobacco.

If we fail in this, we will all count the cost.

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