OPINION: Tobacco Bill needs a clearer view of the science

The tobacco bill being debated at public hearings around the country focuses on nicotine products as a single category, referred to as “tobacco products” – even though they might contain no tobacco at all.

Scientifically, that is problematic. Cigarettes, vapes and oral nicotine pouches all contain nicotine, but they do not expose users to the same toxicants or create the same level of health risk.

The overwhelming burden of smoking-related disease comes from inhaling the products of combustion. Burning tobacco generates thousands of chemicals, including toxic and carcinogenic substances. Smoke-free nicotine products avoid that combustion process.

This does not make vaping or nicotine pouches harmless. But “not harmless” and “as harmful as cigarettes” are two very different propositions.

A major evidence review commissioned by the UK government concluded that, in the short and medium term, vaping represents only a small fraction of the risks of smoking. 

There is also robust evidence on the use of alternative nicotine products as tools to quit smoking. The latest Cochrane living systematic review, updated in August 2026, found high-certainty evidence that nicotine vapes increase quit rates compared with conventional nicotine replacement therapy, such as patches and gum, which are on the WHO’s list of essential medicines. 

Nicotine pouches are a newer category, so the evidence base is less mature. But an important regulatory milestone came in June when the US Food and Drug Administration (FDA) authorised 20 nicotine pouch products to carry a modified-risk claim.

Following scientific review, the FDA gave permission for consumers to be informed that switching from cigarettes to those products lowers the risk of several serious smoking-related diseases.

The question of flavours in nicotine products also requires more scientific nuance than public debate often allows.

Non-tobacco flavours are commonly used by adults who vape, and Yale University researchers have found that adults using flavoured products are twice as likely to quit cigarettes than those using tobacco flavours.

Flavours help smokers quit because they make the alternative sufficiently different from the cigarette it is replacing. It’s as simple as that.

It does not mean every flavour or its descriptor is appropriate. Products that appeal to children raise legitimate concerns. But regulation and enforcement should address youth access, advertising, packaging and product quality without depriving adults of what might be their best chance to quit cigarettes.

The Harm Reduction Society’s tobacco programme is based on a straightforward principle: where abstinence is achievable, it remains the lowest-risk option, but adults who continue to smoke should move to alternatives that expose them to fewer toxicants, such as vapes or nicotine pouches. 

The current hearings on the Tobacco Control (Amendment) Bill therefore raise an important scientific issue for Kenya.

Regulation can acknowledge that cigarettes, vapes and nicotine pouches are not risk-free while also recognising that they are not equally harmful.

Public health is best served when those distinctions are accurately communicated and when policy debates reflect the strength, limitations and direction of the evidence.

The science is continuing to develop. But it is already sufficiently clear that combustion matters, relative risk matters and the difference between smoking and the use of smoke-free nicotine matters too. 

We must hope that Kenya gets a tobacco bill which reflects that truth.