Worldwide, cigarette smoking results in 7.2 million deaths every year, with about half a million of those deaths occurring in Africa .To curb this menace and bring an end to unnecessary deaths, there is urgent need to quickly adopt and promote reduced-risk alternatives aimed at accelerating the transition out of harmful tar-based cigarettes. We should (including tobacco companies) embrace technology and innovations to achieve Sustainable Development Goal 3 on good health and well-being by offering practical smoke-free alternatives to smokers.
Alternatives to cigarette smoking can create a big impact on health in society. Given the undisputed harm caused by cigarettes on human health, the potential negative impacts of e-cigarettes are certainly pale by comparison as there is no tar in e-cigarettes. Stakeholders in the industry must offer alternative products as an important smoking cessation tool. I believe we can have a big impact on public health by promoting alternatives to smoking cigarettes.
Many smokers in Africa are unable – or at least unwilling – to achieve cessation through complete nicotine and tobacco abstinence; they continue smoking despite the very real and obvious adverse health consequences. This is demonstrated by the fact that most smokers in Africa (if not all), are clearly aware of the dangers of smoking, yet they continue to do so. Conventional smoking cessation policies and programs generally present smokers with two unpleasant alternatives: quit, or die.
Millions of men and women who smoke cigarettes regularly are looking for less harmful, yet satisfying, alternatives to smoking. A new generation of alternative tobacco products could offer a breakthrough for harm reduction, appealing to smokers, in a time where current anti-smoking campaigns are considerably not cutting through.
The public health community embraces harm reduction to prevent STD transmission and address drug addiction (e.g., condoms, needle exchanges). This is because evidence showed that prohibition and abstinence don’t work. So, it’s plausible that harm reduction can complement (not replace) traditional tobacco control measures  – leading to still faster smoking declines. We just want smokers to quit by any means: pharmacotherapies including NRTs, counseling, wearables, apps, alternative medicines… whatever works. If they can’t quit that way, then harm reduction reduces harm.
To date, harm reduction approaches have not been widely used in Africa in relation to tobacco smoking. The emphasis has been on population and individual health strategies focused on encouraging existing smokers to quit and preventing uptake among young people. These approaches have been effective and should continue to be encouraged, to help reach the goal of more tobacco-free people in Africa.
The World Health Organisation (WHO) estimates that over a billion people currently smoke cigarettes, and this number is projected to remain largely unchanged by 2025. Globally seven million people die from tobacco annually despite the efforts of the anti-tobacco agencies and world-wide anti-smoking campaigns.
If we embrace these lifesaving alternatives we can begin to save lives now and witness Africa becoming smoke-free in our lifetime.
By Joseph Magero (Director, Campaign for Safer Alternatives)
