National Treasury’s high excise duty on nicotine pouches is ill-advised

Data released last month by the Ministry for Health found that 8,100 Kenyans die from tobacco-related illnesses per year. [Courtesy]

A proposal by the National Treasury to impose high excise duty on nicotine pouches is likely to make this alternative to smoking unaffordable to most Kenyan smokers.

In his Budget Statement presented to Parliament on June 10, National Treasury and Planning CS Ukur Yatani had set the new tax at Sh5,000 per kilogramme. The net effect of this tax will be to make tobacco-free oral pouches more expensive than tobacco.

It is a backward decision especially in a market where affordability is a key buyer consideration. It would make Kenya the first country ever to impose taxes that will make less harmful alternatives more expensive than cigarettes.

Globally, 80 per cent of all smokers live in Low and Middle-Income Countries (LMICs) with an estimated 77 million in Africa. Data released last month by the Ministry for Health found that 8,100 Kenyans die from tobacco-related illnesses per year, more than double our Covid-19 death toll. By comparison, higher-income countries have seen their smoking rates decrease rapidly in recent years, partly due to the widespread availability of safer nicotine alternatives and the large number of smokers switching to these products.

Affordability as an obstacle to tobacco harm reduction in LMICs is one of the issues that exercised my panel during the recent virtual Global Forum on Nicotine (GFN), which brought together a number of leading health experts and advocates.

The second biggest challenge is inadequate policy support by government. Tobacco control has become a moralistic battleground in Kenya that seeks to punish rather than help those who are struggling to quit.

The other major challenge is a lack of support from the World Health Organisation (WHO). The WHO states that smoking cessation should be prioritised and it includes nicotine replacement therapies (NRT) like patches and gums on its list of essential medicines. But the only LMIC that offers a full cessation programme is Senegal. NRT programmes are expensive and for Kenya it is a costly and unrealistic aspiration. Nicotine pouches and e-cigarettes by comparison will cost our government nothing.

In Kenya, we are not doing enough to help smokers quit as made clear by our stagnant smoking rates.

Significant disparities in health outcomes around the world are driven by unequal access to essential health products. Affordability is usually the main culprit, but unfortunately our government has also made restricting access to safer alternatives to cigarettes a policy position.

Most doctors now advocate that smokers use alternative nicotine products to give up cigarettes. In fact, four UK hospitals have just begun offering smokers free e-cigarette starter packs to help them quit smoking.

Sweden, which has the highest consumption of nicotine pouches globally, reports the lowest smoking rates in Europe, and the lowest tobacco-related mortality, according to data published by the WHO. These statistics from Sweden may be the most pertinent for Africa, where there is a tradition of using oral stimulants.

One in three Kenyan smokers wants to quit smoking but only seven per cent succeed. Smokers who are struggling to quit deserve access to all the options available. Kenya has a good record on tobacco control, but we have got our taxes backwards on nicotine pouches. Pricing smokers out of safer alternatives is a severe misstep and will cost lives.

Safer nicotine products are working in higher-income countries. They helped me quit and I believe they can work in Kenya if we allow them to.