OPINION: Harm reduction is key to saving the lives of Kenyan smokers

Every 90 minutes, a Kenyan dies from a tobacco-related disease. Every World No Tobacco Day, policymakers pledge to reduce this toll. Yet, year after year, we see little progress made in helping smokers to quit their deadly habit.

When the Tobacco Control (Amendment) Bill was initiated in the Senate last August, it was a beacon of hope to the public health community, which has been campaigning tirelessly to see advancements in this area. However, 10 months on, progress has stalled. The Bill has yet to move through the Senate, let alone Parliament, meaning that potentially life-saving alternatives to tobacco products continue to exist in legal limbo.

In Kenya, 7.6 per cent of adults smoke, with the prevalence among men rising to an alarming 14.7 per cent. Rural communities are disproportionately affected, with limited access to support for quitting.

Research shows that if Kenya embraced smokeless harm reduction products, we could reduce the annual death toll from smoking to 3,400 by 2060, saving more than 184,000 lives in Kenya in the process . If we’re serious about wanting to reduce our smoking rates and save lives, then the path is clear: we need to embrace tobacco harm reduction now.

As it stands, safer smokeless nicotine products such as vapes and nicotine pouches are unregulated in Kenya, leading to concerns about their safety and underage access. We urgently need to see product standards and laws preventing the sale of smokeless alternatives to under-18s.

These products have the potential to save smokers' lives in Kenya, but it’s important that a balanced regulatory framework is created to ensure that they’re sold and marketed responsibly to adult smokers.

Despite these regulatory challenges, health practitioners and adult smokers who are struggling to quit urgently need clarity on the public health potential of smokeless alternatives to tobacco.

Claims that smokeless nicotine products are just as risky as tobacco are simply not true. Nicotine should never be used by underage individuals, but for adults, the risks posed by nicotine are low compared to tobacco.

The science is clear: it’s the thousands of chemicals that are released when tobacco is burnt that cause the vast majority of harm from smoking, not the nicotine. The UK’s Royal College of Physicians states that vapes are 95% less harmful than cigarettes.

The World Health Organisation (WHO) includes nicotine on its list of essential medicines, thanks to the crucial role that nicotine replacement therapies (NRTs) such as nicotine patches, gums and sprays play in helping smokers quit.

The evidence shows that vapes are even more effective at helping smokers quit than WHO-endorsed NRTs. A recent study of 29,000 smokers by the esteemed Cochrane Library showed that people are more likely to quit smoking long term if they use vapes instead of traditional NRTs. 

It is only by embracing science-backed alternatives to smoking and by putting appropriate regulation in place that we can create a sustainable pathway to help smokers quit.

Countries like Sweden and New Zealand are almost smoke-free thanks to their progressive approach to safer nicotine products. Health authorities in these countries recognise that vapes and nicotine pouches are effective at helping smokers to move away from tobacco and have created regulatory frameworks that support smokers to switch to less risky products. 

Supporting smokers to escape tobacco addiction should be at the heart of any new tobacco control legislation. It is the fastest and most effective way to cut the disease burden from tobacco.

One in every two long-term smokers will die as a result of their habit. We should be doing everything in our power to help those struggling to give up cigarettes once and for all.

We can’t afford to delay any further. The Senate Health Committee must prioritise this Bill and embrace tobacco harm reduction. Thousands of Kenyans’ lives depend on it.

Dr. Kariuki Michael is the Secretary General at Harm Reduction Society and Consultant Paediatrician, Epidemiologist & Researcher.