MAGERO: Time to look at nicotine with new eyes

Monday June 01 2020



The Covid-19 pandemic has changed the way we look at the world in countless ways. One of the most surprising switches in perspective has been how some scientists are now promoting nicotine (but to be clear, not cigarettes) as a potential lifesaver.

Several studies, including the only one to have been peer-reviewed, have suggested that smokers are far less likely to be admitted to hospital with Covid-19.

While the topic is controversial and there are many critics of the data, it has led researchers in Europe to begin tests to see whether nicotine contains properties that protect against infection.

While it’s far too early for us to speculate that nicotine will help in the war against the virus, it might be time to re-examine the part it can play in the battle against smoking-related deaths.

Africa has been slow to embrace — or, perhaps more correctly, slow to be given the chance to embrace — the latest nicotine technology that could help to cut the number of lives lost to smoking.

Despite great success elsewhere in the field of tobacco harm reduction, here it is still considered as a novelty.


The concept is simple. People smoke despite the health warnings in order to get nicotine. But nicotine in and of itself is not the problem: When tobacco is burned, it releases nicotine but also thousands of other toxicants. It’s these the international scientific community recognises as the main cause of the harm in smoking.

The idea of tobacco harm reduction is to encourage smokers to migrate to products that provide them with nicotine without those toxicants produced by burning tobacco in cigarettes.

Evidence shows innovative products such as e-cigarettes, or vaping, and new oral nicotine pouches can do exactly that: Deliver nicotine with far fewer and lower quantities of toxicants.
Tobacco control efforts in Africa mostly concentrate on increasing tobacco taxes, restricting or banning advertising, adding or expanding warning messages and prohibiting smoking in public.

They only advocate quitting smoking without offering a viable alternative to cigarettes.
Policymakers may not be aware that tobacco harm reduction has great benefits. This lack of information, in turn, hinders a reduction in smoking prevalence on a continent that now has more than 77 million smokers.


The United Kingdom, which has an ambitious plan to eradicate smoking by 2030, is encouraging these safer alternatives to cigarettes.

Public Health England (PHE) recently reaffirmed its original statement that e-cigarettes are “at least 95 per cent less harmful than smoking”.

A recent University of London study found that e-cigarettes are nearly twice as effective as nicotine replacement therapy, such as patches or inhalers, for quitting.

Remarkably, over half of the UK’s 3.6 million vapers are ex-smokers.
PHE are not alone. The Royal College of Physicians, the British Medical Association and leading anti-tobacco NGOs, including ASH UK and Cancer Research UK, are actively encouraging smokers to switch to e-cigarettes.

While there is much more research to be done, there is no denying that the UK’s approach is helping to deliver lower smoking rates.

But how do we encourage the move from cigarettes to a safer alternative? Information plays a major role. Smokers seeking lower-risk products should have easy access to communications about their potential benefits and safe use.

Cost is also a big factor. Many smokers cite the desire to save money as one of their main reasons for wanting to give up cigarettes.

But if an e-cigarette is the same price as a traditional cigarette or even more expensive, it is harder to break the habit and the opportunity is lost. Safer alternatives must be affordable if large numbers of smokers are to move away from cigarettes.

Availability is essential and reassurance is needed in the form of regulations enforcing age restrictions and quality control.
The industry is evolving and consistent collaboration is necessary between regulators, scientists and health professionals to ensure public health policy is evidence-based.
Sunday was World No Tobacco Day. If the authorities are serious about reducing the 250,000 African deaths every year from smoking-related disease, they should grab the opportunity of the anniversary to get serious about tobacco harm reduction as a route to creating a smoke-free Kenya.
Africa should wait no more to take up the challenge of becoming smoke-free. We cannot keep letting smokers die when proven life-saving options are available.

Mr Magero, a 2019 INNCO award winner, is the chairman, Campaign for Safer Alternatives. [email protected] @Josephmagero