OHITO: Can Kenya embrace a smoke-free environment?

The allure of smoking remains challenging to stamp out despite the well-known health risks it poses and campaigns to deter it. 

Tobacco manufacturers are offering smoke-free alternatives for adult smokers as a possible way of mitigating the negative health effects of smoking.

Digital penetration has made access to critical information on cessation available to smokers seeking to stop their addiction.

But experts warn that smokers are a difficult cohort to deal with today. Dr Yvonne Olando, a smoking cessation specialist and Nacada director in charge of Public Education and Advocacy says, “We have tried social media campaigns in vain. Users drop out and use data breach excuses even when you allow them to engage anonymously.”

The rapid growth of smartphones and internet access has presented new opportunities to reach smokers with cessation information and support using digital technologies.

These technologies play complementary roles and can be integrated with traditional support modalities such as telephone quitlines and face-to-face clinical cessation counselling, a move Kenyan authorities ought to embrace actively; however, uptake still remains minimal.

“We have cessation clinics at the Dental School, University of Nairobi, and at the Metropolitan Hospital, but users default, disengage, and abandon medicine meant to help them quit smoking,” Olando says.

Philip Morris International, the multinational tobacco company with products sold in over 180 countries with Marlboro among its popular brands, advocates for a smoke-free future.

Similarly, local tobacco manufacturer BAT is pushing for a smoke-free world as they market alternative products in the market.

“Our goal is to offer smoke-free alternatives that have the potential to reduce the risk of developing smoking-related diseases as compared to continued smoking,” says Jacek Olczac, the CEO of PMI, in a new company journal.

“The evidence is clear: smoke-free alternatives can accelerate the end of smoking. The world has to move to help smokers transition to better alternatives. It is time to make smoking history.” 

The world has one billion smokers, while Kenya has an estimated 2.7 million adult smokers, according to Tobacco Atlas.

It is estimated that in Kenya, the smoking prevalence is 7.6 per cent, while youth smoking prevalence stands at 3.5 per cent.

But even as manufacturers struggle with new non-smoking alternatives, experts insist that the best way to avoid the harm of smoking is to not start in the first place.

Eradicating the glamour of smoking by printing public warnings on cigarette packets and banning advertisements of tobacco products in popular media has been one success of health advocates, but not a lasting solution.

At the heart of the smoking habit is nicotine, a well-known component of tobacco and tobacco-containing products and it is one of the reasons people smoke cigarettes.

Cigarette smoking causes serious diseases and is addictive.

Smoking-related diseases such as chronic obstructive pulmonary disease, cardiovascular disease and lung cancer are caused primarily by inhaling harmful compounds largely formed when tobacco is burned.

"Locally, BAT’s introduction of smokeless products such as oral nicotine pouches into the Kenyan market reflects our commitment to meet the preferences of today’s adult smokers,” said Crispin Achola, managing director, BAT Kenya and general manager, East and Southern Africa Markets during the marking of World No Tobacco Day in May. 

He added that reducing the harm caused by smoking requires a dual approach: ongoing tobacco control efforts and the availability of less harmful alternatives for adults who would otherwise continue smoking.

Tobacco use is one of the most common risk factors for non-communicable diseases (NCDs). According to the Ministry of Health, NCDs contribute to nearly 50% of all admissions in public hospitals countrywide.

WHO estimates that 8 million people die from tobacco use every year.

Today, many doctors often pose the question to adult patients during examinations: Do you smoke? How many cigarettes a day or what frequency of tobacco inhalation do you expose yourself to?

Similarly, doctors aver that from epidemiology, if smokers quit, the story does not end there… the risks of developing smoking-related diseases decrease over time.

In Kenya, 69 per 100,000 deaths for individuals aged 30 and above result from tobacco use. Five per cent of all non-communicable deaths result from tobacco use and 55% of all deaths from cancers of the trachea, bronchitis and lung are attributable to tobacco.

Many countries are making great strides in reducing the harms caused by smoking, the leading cause of preventable illness and premature deaths.

The big question in the health sector revolves around national Tobacco Control Plans, and attempts to reduce smoking prevalence substantially.

Mary Muthoni, PS for the State Department for Public Health and Professional Standards, said Kenya continues to enforce the Tobacco Control Act of 2007, which mandates graphic health warnings on cigarette packages and bans smoking in public places. 

However, she noted in a press statement on May 27, despite a decline in tobacco use from 12% in 2014 to  nine per cent in 2022, new challenges have emerged with the rapid proliferation of Novel Nicotine and Emerging Tobacco Products (NNETPs), such as nicotine pouches, vapes and electronic cigarettes. 

These products are often marketed as less harmful alternatives to traditional cigarettes and target young people with appealing flavours and misleading health claims.

Achieving a smoke-free future, however, lies in urging stakeholders to work together on progressive policies that recognise the lower risk profile of smokeless products and prevent youth access to all nicotine products, among others.