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Tuesday, May 28, 2024

Joseph Magero: WHO doing untold harm to Africa’s desperate smokers

The World Health Organisation (WHO) is failing in its duty and Africans have particular reason to feel aggrieved.

Dr Tedros Adhanom Ghebreyesus
Dr Tedros Adhanom Ghebreyesus, Director-General of the World Health Organisation (WHO)

Its latest attack on alternative nicotine products is unscientific, dogmatic and an effective death sentence for millions of smokers who are trying to quit cigarettes, particularly those in less affluent nations like ours.

The WHO’s global tobacco report released earlier this week is a concerted attempt to spread fake news and false myths about life-saving innovations such as e-cigarettes and nicotine pouches.

It argues that these products should be much more tightly regulated.  “Where they are not banned, governments should adopt appropriate policies to protect their populations from their harms,” it declares.

Yet what the WHO omits to mention is that e-cigarettes and pouches are significantly safer than cigarettes and are helping millions of smokers to kick the addiction that might otherwise kill them.

Evidence-based global research shows that alternative nicotine products are roughly 95% less harmful than cigarettes. The influential anti-smoking pressure group Action on Smoking and Health (ASH) is supportive of alternative nicotine products and say they “have proved to be an important gateway out of smoking, not into it”.

This cuts no ice with the WHO, however.

Rather than focus on the all-important goal of beating smoking and saving lives, the WHO chooses to turn its guns on vaping and tobacco harm reduction. It clearly finds it more important to fall into line with the narrow-minded ‘quit or die’ approach trumpeted by its billionaire sponsors, such as Mike Bloomberg.

Besides being riddled with biased anti-vaping, anti-harm reduction scaremongering and false claims, the report’s entire direction of travel is nonsensical. It seems to prefer a miscellany of data that make it impossible to see all the positive results it wants us to believe.

The WHO’s own Framework Convention on Tobacco Control (FCTC) explicitly defines “tobacco control” as “a range of supply, demand and harm reduction strategies” to reduce tobacco consumption, but its practical endorsement of tobacco harm reduction is woefully absent.

While it has been strongly supportive of harm reduction in other contexts, such as the use of condoms to reduce HIV transmission, the WHO gets tobacco harm reduction very wrong.

Its qualified support for products such as nicotine gum and nicotine patches rings particularly hollow in Africa, where they are priced well beyond the reach of most smokers.

It is Africa where harm reduction is most urgently needed. While smoking rates fall around the globe, our continent is an unhealthy outlier, recording rates that are either stagnant or increasing.

In Kenya alone, two-thirds of smokers want to quit but only one in 10 who tries to do so actually succeeds.

A recent International Tobacco Control report on Kenya highlighted “the need to enhance access to physicians and other affordable cessation services and treatments for Kenyan tobacco users, such as Nicotine Replacement Therapies (NRTs) and quitline services, in order to increase quit attempts and successful quitting”.

Already this year, 4,200 Kenyans have died as a result of cigarette smoking.

Yet lawmakers in Kenya, and Africa as a whole, take their cue from the WHO in regulating and taxing e-cigarettes and nicotine pouches. Pouches, which would appear a pertinent solution for our continent, where there is a tradition of using oral stimulants, were even suspended from sale in Kenya.

Instead of providing reliable and trustworthy information about these lifesaving products and making them readily available, authorities treat them as if they are just as dangerous as traditional combustible cigarettes.

CASA and other advocates of tobacco harm reduction recognise that it’s the burning of tobacco that causes all the main diseases from smoking, not the nicotine.
The evidence-based concept of tobacco harm reduction recognises that people smoke for the nicotine, but they die from the tar and the 7,000-plus toxic chemicals released when tobacco is burned.

Innovative products such as e-cigarettes and nicotine pouches are giving desperate smokers the chance to quit and save their own lives.

Perversely, the WHO wants to reduce that chance. Instead, it wants prohibition or excessive regulation and prohibitive pricing to deter smokers from switching.

Despite growing evidence that e-cigarettes are the most effective stop-smoking method available and are nearly harmless, the WHO’s latest report doubles down on its opposition.

It is a betrayal of the WHO’s duty to improve public health.

Instead of adopting a dogmatic, unscientific stance against tobacco harm reduction, the WHO should be embracing it as an exciting opportunity to reduce the millions of lives lost to cigarettes at NO cost.

Joseph Magero is chair of the Campaign for Safer Alternatives (CASA)

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