Calculated risk can save many smokers lives

It is from new research by the University of Nairobi that Kenyans are using a variety of oral stimulants, and each carries its own varying degree of risk.

The study titled, “Review of the risks and toxicants of smokeless tobacco, areca nut and khat products available in Kenya” shows users are currently more likely to consume the riskier products such as chewing tobacco, areca and khat.

And it leads us to a simple conclusion: we should be making much greater efforts to encourage these people towards available tobacco-free products that carry a lesser risk, such as nicotine replacement therapies (NRT) and nicotine pouches or, as they are formally known, modern oral products (MOP).

This is the same principle that guides the organisation I represent, Tobacco Harm Reduction Kenya. Tobacco harm reduction is all about helping smokers who can’t or won’t quit to move away from cigarettes to alternative nicotine products that pose significantly less risk. One of the biggest challenges we face at THR Kenya is convincing policymakers that tobacco control needs to be more evidence-based than the traditional quit-or-die approach.

For many people – including some who should know better – tobacco and nicotine are inextricably linked. But, although people smoke cigarettes for the nicotine, it’s the burning of tobacco that causes the vast majority of the disease from smoking. With alternative nicotine products, such as oral pouches and e-cigarettes, there is no burning. According to the World Health Organisation, nicotine does not cause cancer, and thereby any risk is significantly diminished. Sweden, for example, has the highest consumption of pouches and the lowest smoking rates in Europe. Tellingly, the Swedish rate of tobacco-related lung cancer for men is less than half the EU average.

Compared with many of the oral products used in Africa, Sweden’s smokeless tobacco pouches – or snus – have low levels of carcinogens and other toxicants.  As the report points out, tobacco-free MOPs have the potential to be even less harmful than Swedish snus. The fact that they do not require combustion and do not contain tobacco means that these products have a risk profile close to that of licensed NRTs.

Internationally, they are also helping more adult smokers to quit successfully than NRT products such as lozenges, gums and patches, which are on the WHO’s list of essential medicines. A study in Kenya earlier this year suggests they could be just as successful in cutting our stubbornly high smoking rates.

Market research company Ipsos interviewed scores of Kenyan smokers who had tried to quit using oral nicotine pouches before the products were suspended from sale by the Government.

The users said they viewed pouches as a safer and healthier alternative to cigarettes and most said they used them as part of their “quitting journey”.

Magero is a member of Tobacco Harm Reduction Kenya.