LINDI: Nicotine pouches: Tobacco industry experimenting with youth

At any time, there are thousands of Kenyans addicted to tobacco products who are struggling to quit.

The 2014 Global Adult Tobacco Survey reported 77.4 per cent of current tobacco smokers in Kenya were thinking of quitting.

 They are all running away from a sure end: Tobacco use is linked to lung cancer, cancers of the mouth, oesophagus, bladder, kidney, and pancreas. It is also the main cause of chronic obstructive pulmonary disease, and cardiovascular diseases. The list is endless.

 At least 2.5 million Kenyans use different forms of tobacco, which kills at least 9,000 of them every year, and leaves thousands more severely sick and disabled, according to the Ministry of Health.

 Nicotine is the main addictive substance in tobacco. It is the chemical that addicts smokers to cigarettes till death. It is reportedly as addictive as cocaine or heroin.

 But the good news is, there are scientifically proven ways, sanctioned by the World Health Organization, that help smokers quit.

In Kenya, there are support groups and clubs in schools and universities to help smokers quit. The National Authority for Campaign against Alcohol and Drug Abuse has also introduced a toll-free quit line 1192 to assist tobacco users who want to stop smoking.

The Pharmacy and Poisons Board has also registered drugs such as Zyban (Bupropion) and Champix (Varenicline), to help with smoking cessation. These are taken with doctor’s prescription.

In fact, smoking cessation therapies in public hospitals are covered by the National Hospital Insurance Fund.

Medics may also recommend nicotine replacement, which uses medically approved products that supply low doses of nicotine. The goal of this therapy is to cut down on cravings for nicotine and ease the symptoms of nicotine withdrawal.

Smokers in Kenya have a wide array of help options to quit. Indeed, there could now be more people who formerly smoked than people who currently smoke!

Because of these declines in smoking, cigarette manufacturers are now innovating and rebranding their public image to maintain the bottom line.

They do this by expanding product portfolio, which are aggressively marketed to youth and young adults. The oral nicotine pouches, for instance, are sold on online platforms in total disregard to the tobacco control law. This means that even under 18 can order the products online.

They are also deceptively touted as “safer” than cigarettes, in a programme they call “harm reduction”.

Through the deceptive safety argument, tobacco companies have recruited millions of new nicotine users around the world. Early this year, the Kenya Parents Association warned many students in primary and secondary schools are already getting hooked on nicotine pouches.

The products are also available in a variety of flavours and in different nicotine strengths from strong to stronger.

With the flavourings, nicotine dependency is thought to be exacerbated because the flavours hide the negative experiences associated with nicotine and may induce pleasure on their own.

There is no long-term data to show nicotine pouches are an effective way to quit tobacco. WHO does not recommend the use of these products.  

What is clear is that nicotine pouches are a source of a highly addictive chemical that is unhealthy. Side effects of use include irritation of the gums, sore mouth, hiccups, nausea and most importantly, nicotine addiction which increases relapse risk with other tobacco products.

For adolescents, nicotine addiction compromises brain development. In pregnant mothers, it affects the unborn baby and can cause miscarriage.

That is why Kenya must keep a lid on these products until such a time as WHO advises. In October 2020, Health Cabinet Secretary Mutahi Kagwe declared that the products were illegally registered at the PPB. 

Since then, we have seen a curious increase in deceptive articles on the mainstream media peddling arguments that by restricting the sale of nicotine pouches, the Ministry of Health is denying users their right of choice.

What the promoters are asking Kenya to do is to basically allow the tobacco industry to conduct a large-scale experiment on our entire population. Is that what Kenyans want? 

WHO has already warned that without long-term data, the government would be reckless to authorise the use of these products.

Acting on this wisdom, Germany has banned the sale of nicotine pouches. They also continue to be banned in Australia, Canada, and Norway.  

This is the route Kenya must walk. 

Thomas Lindi is the National Coordinator of the Kenya Tobacco Control Alliance, the national umbrella body for all health promotion organisations involved in tobacco control