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Stakeholder canvass alternatives to cigarettes towards achieving a smoke-free Nigeria
By Tumininu Ojelabi Hassan
Stakeholders have canvassed for alternatives to cigarettes as one of the Tobacco Harm Reduction (THR) strategies towards achieving a smoke-free Nigeria. This is as a result of the social-economic impact and health risks associated with tobacco smoking.
The stakeholders, which include public health experts, researchers, academics, non-governmental organisations, students, and the media, made this call at a roundtable event tagged, “Achieving a Smoke-Free Nigeria: Learning from Sweden”, organised by ValueFronteira Limited, which held in Ikeja, Lagos State on December 21st, 2023.
The Keynote speaker, Mr. Teslim Shitta-Bey, Managing Editor of Proshare consulting, decried the dangers associated with smoking, which are not limited to death alone, but also economic burden, smoking-related healthcare issues, productivity losses and negative impacts on the environment.
“The dangers associated with tobacco smoking are not limited to death alone. The economic toll is equally staggering, with substantial smoking-related healthcare and productivity losses and negative impacts on the environment. According to a 2015 study by the Center for Public Policy Alternatives and the Nigeria Global Adult Tobacco Survey (GATS) published by the World Health Organization, Nigerians spend an average of N89.5 billion yearly on tobacco.
Similarly, in a 2017 report by Nigeria Health Watch, 8,004 tonnes of butts and packs of cigarettes wind up as toxic trash each year, creating a severe ecological impact that is quite detrimental and damaging. In addition, smoking contributes to a rising tide of non-communicable diseases,” he said.
Like other countries, he urged Nigeria to gear towards non-combustible risk reduction tobacco alternatives, adding that Sweden’s innovative approach to tobacco harm reduction is a stupendous inspiration for Nigeria.
To achieve a smoke-free future, he stressed the need for Nigeria to emulate Sweden’s example by embracing harm-reduction strategies and promoting smoke-free products, and most importantly to tailor strategies to Nigeria’s context.
He proposed the reduction in prices of e-cigarettes, which are significantly less harmful than combustible cigarettes, adding that this would reduce the rate of smoking by 60 percent.
“Despite e-cigarettes being significantly less harmful than combustible cigarettes, they are more expensive in Nigeria, with prices ranging from N4,500 to N50,000 for 2nd to 4th generation devices generally affecting their affordability.
This is a huge challenge because in a recent study by THR Nigeria more than 60 per cent of the current smokers would reduce or quit smoking if there were a significant reduction in e-cigarette prices, or if the products were more easily accessible. Policy makers can play a significant role in this respect by properly classifying THR products as belonging to the health category and reducing the associated excise taxes,” he suggested.
With the aim of replicating Sweden’s success, Shitta-Bey emphasized the importance of adopting control measures, such as revisiting and enforcing tobacco harm reduction policies, launching public awareness campaigns, collaborating with the media, strengthening knowledge among healthcare professionals, and promoting the affordability of harm reduction products.
In his remark, a Public health expert, Dr. Oyekanmi Imoleayo, opined that Nicotine, an addictive ingredient contained in tobacco has resulted in daily deaths of young people many of which are underreported.
“When we look at the effect of cigarette smoking broadly, there are exceptional cases that smokers may live long but on the day-to-day practice, you see a lot of young people that died of smoking and were not been captured by data. Data has shown that people die from smoking daily.
The reason why people smoke most of the time is because of the nicotine present in tobacco but if we can get alternative that people can take and avoid tobacco that comprises of other chemicals that are harmful to the body, we can achieve the 5% benchmark of a smoke-free environment,” he remarked.
In his address, Prof. Nnanyelugo Ike-Muonso, the President of ValueFronteira Limited, revealed that Nigeria is one of the African countries with the highest burden of tobacco-related diseases and deaths, he therefore called for the acceptance of tobacco harm reduction (THR) strategies, as well as the need to emulate Sweden for Nigeria to become smoke-free in the shortest possible time.
On a positive note, he further revealed that Nigeria recorded a decline in smoking-related death rate from 28,876 annually as of 2021 to 16,137 annually as of 2023. Also, the rate of smoking reduced to 11 million smokers in 2015 from approximately 13 million in 2021 and tobacco smoking prevalence dropped from 7.5% in 2000 to 6% in 2015, with an anticipated further decrease to 5% by 2025.
“Nigeria unarguably needs to emulate Sweden to become smoke-free in the shortest possible time. In a 2021 study by Marco Castrodori of the Center for the Study of Economies in Africa (CSEA), Nigeria recorded 28,876 tobacco smoking-related deaths annually, imposing an economic burden of approximately N526.4 billion in treatment costs.
A glimmer of hope, however, surfaces as recorded deaths have declined to 16,137 annually as of 2023. Again, a study on the Current Prevalence Pattern of Tobacco Smoking in Nigeria by Adeloye et al. (2019) published in the BMC Public Health journal reported similar declines in smoking rates, which fell from approximately 13 million smokers in 2012 to around 11 million in 2015. Similarly, in 2022, the Global State of Tobacco Harm Reduction report, further updated in October 2023, showed that between 2000 and 2023, Nigeria witnessed a commendable decline in smoking prevalence.
The tobacco smoking prevalence dropped from 7.5% in 2000 to 6% in 2015, with an anticipated further decrease to 5% by 2025. While these numbers reflect progress, more strategic adoption of tobacco harm reduction techniques will accelerate these achievements,” he stated.
Ike-Muonso attributed the significant decline in smoking prevalence to the expansive adoption of THR measures and THR products, which are alternatives to smoking, purposed to reduce the harm associated with conventional cigarettes.
Examples of THR products include Snus, heated tobacco, e-cigarettes and nicotine pouches, which are viable alternatives to combustible tobacco.
He implored the Nigerian government to implement effective tobacco harm reduction policies, which ensure access to non-combustible tobacco alternatives through regulatory frameworks, public awareness campaigns, and collaboration with the media. Adding that, promoting the affordability of harm reduction products is imperative to ensure their accessibility to the population.
He stressed the need to strengthen knowledge among healthcare professionals and the general public about THR methods and products through organizing training programs, educational initiatives, and integrating THR into existing healthcare systems.
He called for a concerted effort towards confronting the prevailing challenges of THR in Nigeria including insufficient awareness, cultural disparities, and affordability issues through collaboration with the media, healthcare professionals, and policymakers.
“Unlocking the full potential of THR in Nigeria requires confronting prevailing challenges, including insufficient awareness, cultural disparities, and affordability issues. A concerted effort is necessary, involving collaboration with the media, healthcare professionals, and policymakers. The dissemination of accurate information through the media can dispel misconceptions surrounding THR, fostering a more informed public. Engaging healthcare professionals ensures that these alternatives are integrated into the broader healthcare framework, encouraging smokers to consider THR a viable option. Policymakers play a crucial role in crafting regulations that facilitate the accessibility and affordability of THR products. By addressing these challenges collaboratively, Nigeria can pave the way for a healthier, smoke-free future, demonstrating a commitment to public well-being and global leadership in tobacco harm reduction,” he urged.
In his contribution, Prof. Adi Bongo, Professor of Economics at the Lagos Business School, recommended social communication, educational and behavioural interventions as solutions to enable behavioural change in addicts as opposed to implementing tax policies, which would increase the country’s crime rate using the United States as an example.
“With about 50 per cent of Nigerians below the poverty line, people think that issues with smoking are not a major problem, when in reality, it is. United States government used tax policies, such as excise tax to discourage smoking, which led to an increase in the price of cigarettes and increased the crime rate.
When people are addicted to certain substances, it takes quite a lot to get them off the hook because even if the price increases, such people are not likely to reduce consumption; instead, crime increases to fund their ability to buy it. What really works is educational, behavioural interventions that can help people change their habits. Also, religious circles, academic institutions can employ social communication to help people get over this habit,” he advised.
