Kenya lags in adopting smoke-free tobacco alternatives

Kenya falls behind in shift towards smoke-free tobacco alternatives. [iStockphoto]

There are rising concerns about the effectiveness of measures that authorities in Kenya are taking to curb addiction and its harm to consumers' health.

As the world marks World No Tobacco Day, a new report has shown that Kenya's overall performance in transitioning towards a smoke-free future appears concerning, despite leading in the acceptability of alternative products such as nicotine pouches.

“Kenya's high acceptability score for nicotine pouches indicates a recognition of their potential, but the practical barriers of cost and availability hinder their effectiveness in driving down smoking rates,” Path to Smoke-Free Global Ranking.

Kenya currently faces a substantial public health burden from combustible tobacco, with approximately 12,000 adults dying each year from smoking-related diseases.

While adult smoking prevalence has decreased from 15 per cent in 2000 to 8 per cent in 2025, this decline is deemed insufficient to resolve the problem within a generation.

The report has shown that Kenya is significantly lagging compared to its African counterparts and global leaders in fostering a smoke-free society.

According to the “Path to Smoke-Free” global ranking, which assesses 101 countries on their readiness to transition away from harmful combustible tobacco, Kenya ranks 75th overall, placing it in the lower half globally.

The report attributes this disparity to challenges in Affordability, where Kenya is ranked 60 out of 101, and Accessibility, ranking 74 out of 101, for these less harmful alternatives.

The current excise regime and proposed restrictions risk making alternatives to cigarettes, such as nicotine pouches and vapes, as difficult to access and as expensive as traditional cigarettes, thereby negating their potential as a harm reduction tool.

“How can anyone support anything to do with Tobacco? It has caused great Havoc,” Dr Peter Harper, an oncologist, acknowledged the impact of combustible cigarettes.

This, while proposing smoke-free alternatives for Tobacco for harm reduction.

The oncologist believes that banning tobacco and other nicotine products does not work; in fact, it does not help reduce addiction and consumption.

If anything, it opens the market for untaxed and unregulated products, whose impact on health is the same, if not worse.

“Quitting is much harder than non- smokers realise. Safer alternatives help people switch or eventually quit,” the oncologist has reiterated that it is far more effective than traditional quit clinics.

Currently, A bill in parliament, The Tobacco Control Amendment, in Kenya, a key legislative reform, aims to modernise regulations to cover new products like nicotine pouches, vapes, and e-cigarettes.

The proposals in the draft bill include strict manufacturing approvals, bans on flavoured nicotine, tightened advertising restrictions, and a focus on protecting youth.

The British cancer specialist has cautioned Kenyan lawmakers against imposing overly stringent regulations on smoke-free nicotine alternatives, arguing that such measures could backfire and drive smokers toward more dangerous illicit cigarettes.

Despite this, the Path to Smoke-Free report also shows that Kenya is ranked amongst the first in the world for having a regulatory framework that recognises innovative products in the tobacco industry.

“We have known for many years that smoking is related to cancers and to many other diseases. But what we haven't known for a long time is whether the nicotine can be delivered in a different way to have some form of harm reduction,” Dr Harper said.

“The best thing to do if you're a smoker is to quit smoking,” Dr Harper.

According to the oncologist, clinical evidence has shown that over 60 per cent of lung cancer patients cannot quit smoking, despite clear medical advice and personal stakes.

“Banning has never worked, and basically, that is not a process that is going to work.”

The medical oncologist has said that having a one-size-fits-all taxation against nicotine in all forms pushes people to the combustible cigarette, which is the worst form of nicotine that you can get because of all the toxicity of smoke.

He emphasises that while quitting remains the ideal, prohibition-style policies have repeatedly failed.

Dr Kariuki Michael, Secretary General, Harm Reduction Society of Kenya, said that for Kenya to truly leverage the public health potential of safer alternatives for smokers, such as pouches and accelerate its path to a smoke-free society, policymakers must re-evaluate the current tax and access frameworks.

“By ensuring that less harmful alternatives are genuinely more accessible and affordable than combustible tobacco, Kenya can provide its 2.3 million smokers with a viable and effective means to transition away from cigarettes. This is not just about policy, it is about saving lives and setting an example for the entire African continent,” Dr Kariuki said.

Africa Consumer Advocacy Foundation (ACAF) Executive Director, Anselm Maina, echoed that Kenya has made important strides in recognising safer alternatives to harmful tobacco products.

“But recognition alone is not enough. When safer alternatives remain expensive or difficult to access, millions of adult smokers are left without viable pathways to move away from cigarettes,” Mr Maina said.

He adds, “If we are serious about saving lives, policies must empower, not hinder, smokers who are trying to switch to less harmful options”.

Kenya, with 65 per cent of its population under the age of 25, faces a critical window to prevent a future wave of non-communicable diseases. Harper warned that the ageing population in Kenya could inherit the costly health burdens seen in Europe.

Existing clinical evidence shows that safer alternatives for harm reduction are more effective than traditional alternatives, which are about 3 per cent.

In the United Kingdom, the adoption of vaping combined with differential taxation has led to a rapid 10–12 per cent decline in cigarette smoking.

Japan has seen significant drops in smoking rates through heated tobacco products, delivering measurable economic benefits. In Sweden, decades of snus (nicotine pouch) use have reduced tobacco-related diseases to roughly a quarter of the highest rates in Europe and half the continental average.

By contrast, Dr Harper has highlighted the pitfalls of outright bans. For instance, during South Africa’s pandemic-era prohibition, smokers turned to unregulated, illegal cigarettes of unknown quality. Similar patterns emerged with alcohol Prohibition in 1930s America.

“Banning has never worked,” Harper stated.

In Kenya, Traditional quit clinics, such as the one at Nairobi’s Aga Khan Hospital, achieve low success rates when compared to smokers switching to less harmful alternatives.

“Non-combustible products like vapes, heated tobacco, and oral nicotine are estimated to be 90–98 per cent less harmful by avoiding the toxic combustion of cigarettes,” Dr Harper said.

While nothing is entirely risk-free, Harper argued the relative risk reduction is substantial and supported by years of evidence.

According to Dr Vivian Manyeki, a harm reduction advocate, it is important for the bill seeking to amend the Tobacco Control Act to incorporate harm reduction.

“The policymakers should not have an approach of one size fits all for nicotine products; each product should be regulated on its own,” she said, noting that there is an issue of historical distrust.

Data by the World Health Organisation (WHO) shows that about 70 per cent of all lung cancer cases in the world are attributed to tobacco smoking.

“In 2022, lung cancer was the leading cause of cancer cases and deaths, with an estimated 2.5 million cases and 1.8 million deaths,” according to the WHO global data.

In Kenya, there were 903 new lung cancer cases, and another 822 deaths in the same period.

Today, WHO data shows that 1.2 billion people in the world used tobacco in 2024 alone.