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Government urged to promote use of smokeless nicotine replacement therapies

Founder and secretary-general Harm Reduction Society

By Benard Mulwa

The government has been called upon to seek safer alternatives to save lives and reduce the public health burden caused by cigarette smoking. This comes even as Public Health Principal Secretary Mary Muthoni said the government proposes to “wipe out” nicotine products.

Dr Michael Kariuki, secretary-general of the Harm Reduction Society, said: “Alternative nicotine products like regulated vapes and oral pouches are scientifically proven to be far less harmful than cigarettes and are the most successful method for helping smokers to quit.

Harm reduction is a public health strategy that has been used successfully for years to address various health-related behaviours, including drug abuse, alcohol consumption, reproductive health and smoking. A good example locally are the methadone clinics for opioid users.

The purpose of tobacco harm reduction is to minimize the health risks associated with smoking by offering pragmatic alternatives that carry a lower level of risk. WHO’s FCTC Part 1 Article 1 (d) defines “tobacco control” as a range of supply, demand and harm reduction strategies that aim to improve the health of a population by eliminating or reducing their consumption of tobacco products and exposure to tobacco smoke.

“Regulation of these products is, of course, necessary, to protect children and the youth. However, that regulation should be evidence-based and proportionate to the risks posed, after taking into consideration the smokers who need these therapeutic products.”

Joel Sawa, spokesperson for Campaign for Safer Alternatives (CASA), said: “If smokers can’t or won’t quit, we need to help them switch to safer alternatives. The best way to save lives is to ensure that tobacco-free products like regulated nicotine pouches and vapes are affordable and accessible.

“Wiping them from the market leaves smokers with no option but to keep smoking. It’s unthinkable that policymakers are even considering indiscriminate, ill-informed and nonevidence-based actions against them without any heed to this potential mishap.”

The experts, speaking at a joint press conference in Nairobi, pointed to the growing weight of international evidence showing the beneficial impact of alternative nicotine products,

Researchers at the University of Nairobi have found that there was little or no quality control in terms of levels of toxicants or psychoactive ingredients of oral stimulants such as khat and smokeless tobacco products such as pan, tambu, gutkha, Kuber, toombak, sniffed and chewed tobacco in Kenya, which put their users at considerable health risks and that regulated oral nicotine products carry similar levels of toxicants and risks as nicotine replacement therapies which feature on the WHO’s list of essential medicines.

The US Food and Drug Administration says Modified Risk Tobacco Products (MRTPs) “will significantly reduce harm and the risk of tobacco-related disease to individual tobacco users and benefit the health of the population as a whole”1 .Such MRTPs are regulated nicotine pouches and vapes which are largely used in countries such as Sweden and the UK to assist cigarette smokers to quit.

In countries worldwide, from the UK and France to the USA, Pakistan and New Zealand, innovative alternative products are already helping smokers who had despaired of ever being able to give up their deadly tobacco habit.

Non-Tobacco Nicotine products do not contain tobacco and extensive international research has found them 95% less harmful than traditional combustible cigarettes.

 Studies show that regulated modern oral nicotine products carry similar levels of toxicants and risks as nicotine replacement therapies (NRTs), which are on the World Health Organization’s (WHO) list of essential medicines.

 Sweden is about to achieve the status of being the first country in the world to become officially smoke-free after making safer alternatives acceptable, available and affordable to adults. It now has the lowest smoking and tobacco-related disease rates in Europe.

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