Public health advocates push for science-led harm reduction policies in tobacco control

 

Botswana, like many countries in Africa, is grappling with tobacco-related health challenges.

According toThe Anti-Tobacco Network (ATN), a non-profit, non-governmental organization in Botswana that works to reduce tobacco use, around 3.8% of adults are exposed to tobacco smoke at home, 67.4% are exposed at bars and nightclubs, and 7.5% are exposed on public transportation. The report also sates that 95.3% of adults believe smoking causes serious illness, and 95% of adults believe smoking causes serious illness in non-smoker.

While efforts such as the Tobacco Products Control Act have been implemented, public health experts believe integrating harm reduction strategies could further address the growing prevalence of traditional smoking and non-combustible nicotine products.

This perspective was highlighted during the fourth Harm Reduction Exchange held in Nairobi, Kenya. The event brought together experts and policymakers from across Africa, including representatives from Southern Africa, to discuss how science-driven approaches can improve tobacco regulation and policy development across the continent.

Recently, a panel featuring businessman Linus Gitahi, Dr. Vivian Manyeki, Prof. Issa Wone, and Emmanuel Mbenza Rocha from the DRC convened during the fourth Harm Reduction Exchange held in Nairobi, Kenya.

The event aimed to promote science-driven approaches in tobacco regulation and policy development across Africa to enhance public health outcomes.

Themed “Enabling Innovation in Harm Reduction through Science-Led Regulation and Policymaking,” the gathering brought together public health experts, policymakers, media representatives, and stakeholders from the hospitality and liquor trade sectors. Experts such as Dr. Mercy Korir, Dr. Mohammed S. Eltaweel, Wilson Box, Chimwemwe Ngoma, Prof. Karl Fagerström, and Joseph Magero contributed through presentations and panel discussions.

Dr. Vivian Manyeki, a Kenyan public health specialist, explained the significance of harm reduction, stating that it focuses on “policies, programs, and practices aimed at reducing the negative health, social, and legal consequences of substances such as tobacco, alcohol, and opioids.” She emphasized the need for governments to strengthen tobacco control laws while incorporating harm reduction strategies, such as allocating tobacco taxes to public health initiatives and increasing access to harm-reduction tools.

Wilson Box, Projects Executive Director of the Zimbabwe Civil Liberties and Drug Network, highlighted disparities in tobacco regulation across Africa. While some nations follow the WHO Framework Convention on Tobacco Control (FCTC), others face resource challenges. “High-income countries often have advanced regulatory frameworks, but low- and middle-income countries struggle to regulate emerging nicotine products effectively,” he noted.

Dr. Mohammed S. Eltaweel shared Egypt's progress in harm reduction, describing the availability of buprenorphine for opioid addiction treatment and the regulation of alternatives to traditional cigarettes. “These initiatives have significantly reduced public health burdens and related social issues,” he said.

Dr. Michael Kariuki, a Kenyan expert, underscored the role of Nicotine Replacement Therapy (NRT) in reducing smoking-related harm. He noted that products like nicotine patches, sprays, and lozenges are safer alternatives, with no evidence linking them to serious health risks. He also highlighted the importance of media in raising awareness about lower-risk products and fostering dialogue on harm reduction strategies.

The event shed light on differing regulatory approaches across the continent:

Kenya has made progress with the Tobacco Control Act of 2007, distinguishing between combustible and non-combustible products.

Nigeria’s Tobacco Control Act lacks specific provisions for non-combustible products, focusing instead on general tobacco control.

Ghana, through its Food and Drugs Authority (FDA), has prohibited non-tobacco harm-reduction products like shisha.

The 2024 Harm Reduction Exchange concluded with a resounding call for evidence-based strategies in tobacco regulation. By embracing harm reduction approaches, policymakers can save lives, lessen public health burdens, and develop targeted regulations for a more equitable societal impact.