Harm reduction key in public health strategies and tobacco control

On December 2, 2022

MEDIA has been called upon to play a critical role in accelerating harm reduction efforts by informing and sensitizing cigarette smokers on the availability and benefits of alternative, potentially lower risk products to cigarettes. Speaking during the second harm reduction exchange conference for African journalists held in Nairobi, Kenya yesterday, Integra Africa Principal Tendai Mhizha said the media is key in handling misinformation and disinformation in tobacco harm reduction discourse that is actually perpetuating the death and disease caused by people continuing to smoke combustible cigarettes.

“There has been a lot of disinformation surrounding the topic of nicotine and the alleged negative effects that e-cigarettes have on public health. This has led to policies that disfavour risk reduces products and narratives that completely deny their benefits. The media has the difficult responsibility to curb the scourge of disinformation and misinformation on harm reduction just like on other socio-political stances that are prescriptive and do not uphold consumers’ right to healthier lifestyle choices,” Dr Mhizha said. She said traditional cessation and smoking prevention norms are not the only ways that smokers who cannot or do not want to quit can make healthier choices that cause less harm to themselves and those around them.

She said the Harm Reduction Exchange cast a spotlight on alternative ways to reduce harm among tobacco smokers. Held under the theme: “ Harm Reduction: Making a difference in Africa,” the conference focused on the progress being made through harm reduction strategies in all fields related to public health such as drug and alcohol abuse, excessive sugar consumption, skin lightening and other addictive and behavioral practices. A wide array of harm reduction strategies and initiatives that are deployed towards reducing unnecessary deaths through non-communicable diseases were presented and discussed during the conference.

Prof. Abdoul Kassé, a world renowned and awarded Oncologist and a professor of surgery at the Cancer Institute in Senegal, said that harm reduction is a powerful public health tool that has the potential to reduce cancer by 30 percent and should be at the centre of all public health development strategies. He said harm reduction has already benefited many people in public health and is the most viable alternative in tobacco control. Prof. Kasse’ said harm reduction applies to areas where there is a need to reduce the harm associated with a practice or consumption of a substance that is overused in society leading to increased morbidity and mortality. “Innovative harm reduction initiatives will help to keep more Africans alive.

Tobacco Harm Reduction initiatives, including the use of popular e-cigarettes, nicotine patches and chewing gums, have continued to generate a lot of misunderstanding in both the public health community and in the media. However, there is evidence that the use of potentially less harmful alternatives than cigarettes for those who are not willing or cannot give up smoking with currently approved methods may be a solution, not necessarily the best for everyone but by far better than continuous smoking. Where cessation repeatedly fails, switching to less harmful products is expected to result in benefits for many smokers,” Prof. Kassé said. Vivian Manyeki of Kenya said tobacco harm reduction has a solid scientific and medical basis, and it has a lot of promise as a public health measure to assist millions of smokers. “Many smokers 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 and against the multiple public health campaigns.

Conventional smoking cessation proposals should be complemented with alternative but more realistic options through Harm Reduction,” Dr. Manyeki said. Tobacco Harm Reduction was introduced to mitigate the damage caused by cigarette smoking—the most dangerous form of tobacco use, and the leading cause of preventable diseases, including cardiovascular disease, lung cancer, and chronic obstructive pulmonary disease. An ophthalmologist and President of Africa Medical Association and president of the Association of Medical Councils of Africa Kgosi Letlape said nicotine has an addictive potential but plays a minor role in smoking-related morbidity and mortality. Dr Letlape said there is growing interest among experts in novel approaches towards tobacco control and there is an ongoing discussion that reducing the negative effects of smoking can be also achieved by tobacco harm reduction. The key note speakers included Prof Kasse, Ms Bernice Opondi, Joseph Magero, Jonathan Fell, Chimwemwe Ngoma, Clive Bates, Dr Letlape, Dr Vivian Manyeki and Dr Mhizha.