SCIENCE should guide all public health policies.
Surprisingly, such a seemingly obvious principle often needs restating. Particularly now, as we plot our way through the pandemic amid the noise generated by conspiracy theorists and vaccine hesitancy.
It is a principle that also needs to be stressed upon those shaping Kenya’s tobacco control policies as they come under increasing pressure from powerful lobbyists for whom science seems an annoying distraction.
It has become clear that the tobacco control activists in Kenya are dead-set against safer, alternative nicotine products, such as e-cigarettes and tobacco-free nicotine pouches.
They are dismissing global evidence-based research that proves these innovative new products are potential lifesavers.
And the falsehoods these advocates persist in disseminating against these products risk killing millions of reluctant smokers.
In Kenya, activist groups and indeed those responsible for our health policies in Government refuse to concede that it’s tobacco – not nicotine – that causes the harms associated with smoking.
They refuse to admit that alternative nicotine products are 95% less harmful than traditional, combustible cigarettes.
And they will undoubtedly refuse to acknowledge the fact that the most influential tobacco control experts in the USA came together last week to endorse the harm reduction benefits of vaping for adult smokers.
In a momentous report, these eminent scientists called for the rehabilitation of vaping’s public image and emphasized its ability to save lives as a safer alternative to combustible cigarettes.
Science in this form is anathema to the activists deciding our tobacco control policies because it contradicts the dogma that informs its own messaging.
For them it’s a binary choice: quit or die.
In parts of the world that are winning the war against smoking, alternative nicotine products are being embraced as the safest way to give smokers their best chance to quit.
But groups like KETCA are telling the Kenyan Government that these potentially life-saving products should either be banned or made prohibitively expensive through draconian taxes.
Kenya already taxes e-cigarettes at some of the highest rates in the world and are pushing for similar with nicotine pouches arguing that lower rates for nicotine pouches will deprive the Government of much-needed revenue.
But this argument ignores the facts.
Because of the high taxes on e-cigarettes in Kenya, there has been a massive influx of illicit (tax-evading) vapes into the country in recent months.
I have witnessed how they’re now readily available in shops as a direct result of the growing demand from smokers for safer products that work.
This illicit trade in tax-evading e-cigarettes is what deprives the Government of revenue. The situation would be replicated with nicotine pouches if these were taxed beyond the reach of consumers.
In addition to creating a black market, those in charge of regulating nicotine products are blind to the role that these products can play in our country’s battle against tobacco.
So, for their benefit, here is some pertinent evidence-based research about how zero-tobacco nicotine products are helping millions of smokers around the world to beat their deadly addiction:
- At least 2.3 million UK smokers have quit smoking completely using nicotine vapes (e-cigarettes), according to the highly respected global body Action on Smoking and Health.
- 3 million US adult nicotine vapers are ex-smokers, according to the Center for Disease Control and Prevention.
Compelling evidence in support of nicotine pouches comes from Sweden, where there is 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.
Snus is the primary form of nicotine pouch used in Sweden, with the BMJ’s Tobacco Control report stating: “Among males participating in a large population-based twin study in Sweden, snus use was associated with smoking cessation but not initiation.”
It adds: “Use of snus in Sweden is associated with a reduced risk of becoming a daily smoker, and increased likelihood of stopping smoking.”
And now comes the new US paper signed by 15 past presidents of the Society for Research on Nicotine and Tobacco.
Its publication in the American Journal of Public Health last week represents the most organised and forthright endorsement of alternative nicotine products by such scientists to date.
There is plenty of evidence that vaping is helping smokers to quit:
- The results of randomized trials, which have shown e-cigarettes outperform other cessation methods such as nicotine patches
- Population studies, the findings of which “are consistent with a near doubling of quit attempt success”
- Cigarette sales, which decrease rapidly as vaping sales increase
- And the unintended consequences of policies restricting vaping, such as bans that unintentionally shot up cigarette smoking.
How will those advocating for a tobacco-free Kenya respond to this powerful application of science? We must wait and see.
But we must not continue to allow science to be ignored if we are serious about reducing the 8,000 Kenyan deaths caused by tobacco every year.
By Joseph Magero
Chairman: Campaign for Safer Alternatives