Joel Gitali, chair of the Kenya Tobacco Control Alliance (KETCA).
As Kenya stands on the cusp of enacting the Tobacco Control (Amendment) Bill 2024, a familiar argument is being revived by industry allies. We are told that e-cigarettes and nicotine pouches are merely tools to help adults quit smoking. We are warned that regulating these products will deny smokers a "safer alternative."
However, the statistics on tobacco and nicotine use prevalence in Kenya contradict this position. The 2022 Tobacco Alcohol and Drugs Substance Abuse Survey (TADSAS) indicates that the highest tobacco use rates are among adult males aged 45-54 at 14.7%. These are the smokers who either need to quit smoking or ‘migrate to safer alternatives’.
Yet only 2% of this age group uses e-cigarettes. On the contrary, the 2023 Report on the Status of Drugs and Substance Use Among University Students indicates that 3.2% of youth aged 15-24 use tobacco products, whilst use of e-cigarettes and nicotine pouches is highest in Kenya amongst university students from this age group at 5.8% and 4.2% respectively. The group with the lowest tobacco use prevalence is the group with the highest use of cigarettes and nicotine pouches. They can hardly be said to be in need of ‘alternatives’ to a product they do not use.
Further, available data indicate that e-cigarettes and nicotine pouches are marketed through fruity flavours and social media tactics that are appealing to children and young people. The main reason given for use of e-cigarettes in the TADSAS 2022 report was that the products came in likeable flavours, while the main reasons for nicotine pouch use were that they were perceived to be fashionable and to have nice flavours.
The Data on Youth and Tobacco in Africa Kenya Report 2024, a pioneering household survey of adolescents aged 10–17 in Kenya, indicates that 2 out of 5 adolescents surveyed were exposed to tobacco and nicotine product advertising in media platforms. Further, e-cigarette consumption starts as early as 9 years, which debunks the use of these products by adults for cessation support.
Evidence shows that adolescents who use e-cigarettes are three times more likely to have ever smoked combustible cigarettes and twice as likely to be current smokers. Nicotine products are especially harmful to adolescents as they affect their developing brains - they affect the parts of the brain that control attention, learning, mood and impulse control. They have also been linked to raised blood pressure and heart rate, which can cause heart diseases, cancers, including breast cancer, pulmonary diseases, lung injury and metabolic syndrome, including prediabetes.
We see an industry fighting to stay afloat by hooking a new generation on nicotine, not because these products cure smoking, but because they sustain the addiction cycle that keeps profits flowing while adding to our national health burden.
Dr Peter Harper, a champion for "harm reduction," argues in an article that the Tobacco Amendment Bill 2024 will do more harm than good. With respect, we must ask: What is truly harmful—regulating a dangerous substance, or allowing an industry to use Kenya as a laboratory for a new wave of addiction? Dr Harper claims these products are "not for those who want to start smoking." The data suggests otherwise.
This is not "harm reduction." This is harm initiation. We are seeing a phenomenon in Kenya where young people, who would never have touched a traditional cigarette due to its high cost and bitter taste, are being initiated into nicotine through sweet-flavoured vapes. Once the brain is hooked on nicotine from these "safe" alternatives, the transition to traditional cigarettes, or dual use, becomes alarmingly easy.
‘Harm reduction’ dangerously downplays the impacts of nicotine addiction. It claims alternative products "deliver nicotine with a dramatically reduced risk." While the toxicants may be fewer, the addiction remains. Nicotine is the glue that binds consumers to the industry. A smoker who switches to a nicotine pouch is no longer buying cigarettes, but they are still buying nicotine. They are still customers. They are still feeding a system that profits from dependency and deceptive marketing to vulnerable children and youth..
For the tobacco industry, this is not about saving lives; it is about survival. As traditional smoking rates decline in the West, Africa has become the battleground. The industry is fighting to stay afloat by diversifying its portfolio. By recruiting youth who have never smoked into nicotine pouches and vapes, they ensure a "replacement market" for the 12,000 Kenyans lost to tobacco-related deaths annually.
The World Health Organization (WHO) and the Framework Convention on Tobacco Control (FCTC) have repeatedly warned that without strict regulation, these products risk reversing decades of progress.
Proponents often point to Sweden as a success story, citing low smoking rates due to "snus." In Sweden, men have 61% lower lung cancer rates than the EU average.
However, it is intellectually dishonest to compare Stockholm to Nairobi. Sweden regulated snus for decades, built a specific cultural harm reduction framework for heavy smokers, and has robust cessation programs. Kenya does not have that infrastructure. We have porous borders, a thriving informal sector, and a young population of 52% under the age of 19 who are prime targets for aggressive marketing.
We cannot import a Swedish solution to a Kenyan problem when our problem is the mass initiation of non-smoking youth into nicotine.
As the National Assembly reviews this Bill, civil society organisations are demanding that the genuine voices of public health—not industry profits—prevail.
Joel Gitali, Chair of the Kenya Tobacco Control Alliance (KETCA), warns that the industry is exploiting gaps in legislative knowledge. "We saw at the recent COP11 conference in Geneva how the industry tries to advance economic arguments to undermine public health," he said. "Their strategy is to confuse the public into thinking nicotine is harmless. We urge the National Assembly to stand firm against these predatory tactics aimed at our youth."
As we approach World No Tobacco Day, we must ask ourselves critical questions:
1. Whose lives are we saving? Are we saving lives by moving smokers to pouches, or are we creating millions of new nicotine addicts among our 10-year-olds?
2. Where is the data? The TADSAS and DaYTA studies provide irrefutable evidence that the industry's "harm reduction" narrative is deliberately targeting Kenya’s youth. We must follow the data, not the marketing.
3. What is the cost? Dr Harper argues these products cost the government nothing. But what is the cost of a generation reliant on nicotine? What is the cost of increased healthcare burdens from dual use?
We cannot allow "harm reduction" to become a smokescreen for "youth addiction."
The most dangerous disinformation is the lie that a new form of nicotine is safe. Let us build a tobacco-free Kenya, not a nicotine-dependent one.
