Ministry backs mass withdrawal of nicotine products from market

The Ministry of Health is considering mass crackdown on some nicotine products to stop the growing abuse crisis.

A taskforce appointed by the ministry last year warns the country is flooded with nicotine and emerging tobacco products that do not comply with the Tobacco Control Act and its regulations, the primary law that regulates them.

Its report, which the Star has seen, recommends mass withdrawal from the market.

Public Health PS Mary Muthoni said they are ready to implement the recommendations.

The taskforce was commissioned last year to investigate novel nicotine and other emerging tobacco products and their potential impact on public health.

“The taskforce recommends the strict control and regulation of novel nicotine and tobacco products and a withdrawal from the market of those products that do not comply with the provisions of the Tobacco Control Act and Regulations,” its report says.

The taskforce also advised the government to form a multi-agency team to investigate the extent of nicotine proliferation in the country.

It is headed by Dr Andrew Toro, head of the tobacco control division in the Ministry of Health.

Dr Toro said they also evaluated the health risks associated with these products, including their potential impact on youth and vulnerable populations.

They include electronic delivery systems and electronic nicotine delivery systems, and nicotine and non-nicotine containing products such as pouches, e-cigarettes, vape pens, tobacco rolling papers, heat-not-burn devices, heated tobacco, and flavoured tobacco products. 

Dr Toro’s team said the products are misleadingly marketed to young people as “less harmful” or “safer alternative.”

“Some nicotine pouches contain over 11mg of nicotine per pouch which is equivalent to more than 20 cigarettes,” they said.

“These high levels increase the risk of addiction and make quitting more difficult. They also lead to these products becoming gateways to cigarette smoking and the use of other tobacco products.”

The World Health Organization also warns that novel nicotine products can double the chance for non-smokers to start to smoke cigarettes. 

However, the long-term health effects of these products are still not known as they are fairly new and some diseases, such as cancer, take many years to develop.

Dr Toro’s team noted e-cigarettes and vapes have been linked to respiratory and cardiovascular health issues due to the substances in vape aerosol.

“Secondhand vape and e-cigarette aerosols contain harmful chemicals such as; nicotine, diacetyl, a flavouring, volatile organic compounds such as benzene and heavy metals such as nickel, lead, and tin that may predispose to nicotine addiction and cause serious lung disease,” they noted.

The few independent studies that have been conducted on nicotine pouches revealed the presence of tobacco-specific nitrosamines (TSNAs) in most nicotine pouches.

TSNAs are the most significant carcinogens in tobacco products nicotine pouches containing TSNAs increase the users' risk of cancers such as mouth cancer.

The taskforce says although nicotine pouches are marketed as therapies to help in quitting tobacco among addicts, this is a gimmick because most of these novel tobacco and nicotine products contain higher nicotine than cigarettes.

“In fact, they have been shown to double the risk of non-smokers beginning smoking and often lead to dual and even triple use of tobacco and nicotine products,” the taskforce report says.

Health PS Muthoni in a statement said they are implementing the report first by amending the tobacco control regulations.

“The ministry will also ensure that tobacco cessation services are accessible through the Social Health Insurance Fund, emphasising community-based models delivered through outpatient services to address affordability and physical access challenges,” she said.

The team urged the government to fully implement nicotine and tobacco cessation programmes in hospitals.

The WHO Epidemic Report, 2019 notes that there are no cessation services in the majority of healthcare facilities in Kenya. Such cessation services are only available in Mental health departments or within rehabilitation centres.

Currently, Nicotine replacement therapies are available in private pharmacies without a prescription, though neither these NRTs or bupropion medication is covered by the National health insurance Fund.