Yesterday, my colleagues and I attended the fourth edition of Tobacco Harm Reduction Exchange, a forum that brings together experts and stakeholders in the public health sector. This time round, the theme of the forum was “Enabling Innovation in Harm Reduction through Science-Led Regulation and Policymaking”, and the speakers and panelists brought the message home resoundingly.
Harm reduction refers to policies, programs, and practices that aim to minimize the negative health, social, and legal impacts associated with drug use, drug policies, and drug laws. This is in recognition of the fact that as much as drug use exists and is quite prevalent, there is a need to continually address the associated risks to improve the lives of users and those around them.
The experts who were drawn from around Africa and as far out as Sweden looked at tobacco consumption, the dire effects it has on health and life, and the policies that can be crafted to curb it. Harm Reduction is not just a buzzword. It is a set of elaborate programs and strategies whose goals are clear and relatable to all. It is a push towards better physical and mental health, better relationships, healthier families, reduced violence, improved living conditions, and ultimately towards saving lives. These are just a few, otherwise, the benefits of less drug consumption are immense.
Dr. Michael Kariuki, a Consultant Paediatrician, Public Health Specialist, and Epidemiologist, looked at the dangers we face both from combustible cigarettes and smokeless products here in Kenya. Many of them are locally made, unbranded, and unregulated. With the lack of traceable quality control, consumers of products like chewable tobacco, snuff, and khat are unaware of the level of toxicants they are consuming. It is this lack of regulation that opens the field for contamination of tobacco products with illicit intoxicants like cannabis and even harder drugs like cocaine and heroin.
Dr. Kariuki is also a founder member and secretary of the Harm Reduction Society in Kenya.
Worse still, we do not have adequate data to track harm and present it to the Government and other policymakers to inform policy change. In Kenya and other Sub-Saharan African countries for instance, oral cancer rates are underreported due to the limitations of the cancer registries in these countries.
This lack of data also affects reporting by the media, since many houses feel they do not have enough information to craft accurate stories to report. As one in media, I would need clear and current data on the prevalence of different types of tobacco products, cases of harm to health, deaths, and effects on non-users as well as the environment. It would also be important to know the methods of production since this informs the end product. I learned at the forum that the fermentation step increases the harsh effects of tobacco and that it is advisable to skip it as a contribution towards harm reduction.
Sweden came out as a shining example of Harm Reduction with innovative strategies to minimize the harmful effects of tobacco. The country aims to save 3.5 million lives in the next decade with a combination of tobacco control methods and harm minimization strategies. Some of their strategies are the recognition of smoke-free products as less harmful, policy to make smoke-free alternatives more accessible, and fact-based information about products like e-cigarettes which are 95% less harmful than combustible cigarettes.
There was a lot to take home from the forum, with the clearest message being the need to implement harm reduction practices, strengthen control policies, and enforce stringent trading laws to curb the proliferation of black-market products.
“Harm reduction involves policies, programs, and practices aimed at minimizing the negative health, social, and legal impacts of substances like tobacco, alcohol, and opioids. Governments must strengthen tobacco control laws while integrating harm reduction strategies. This includes directing taxes collected from tobacco products toward public health programs and increasing access to harm reduction tools.” Dr. Vivian Manyeki – Public Health Specialist.
