Harnessing tobacco harm reduction: Lessons from Sweden and Japan for a healthier Nigeria

Sweden’s bold embrace of Tobacco Harm Reduction (THR) is a masterstroke that has yielded extraordinary results. While the world grapples with a deadly tobacco epidemic, Sweden has shown us a path to a healthier future. By prioritising the well-being of its citizens over the profits of the tobacco industry, Sweden has proven that safer alternatives can dramatically reduce smoking rates and save countless lives. It’s time for other nations, including Nigeria, to follow suit.

Sweden is not alone in its THR success. Japan has also embraced the concept with the introduction of heated tobacco products (HTPs). Unlike traditional cigarettes, HTPs heat tobacco without burning it, significantly reducing the production of harmful chemicals. These products have rapidly gained popularity in Japan, with over 10 percent of Japanese smokers switching to HTPs in just a few years. The results are impressive: a study by the Japanese Ministry of Health found that HTPs reduced smoking-related biomarkers by up to 90 percent. This demonstrates that THR can be effectively implemented on a large scale, leading to substantial health benefits.

So, how does THR work? The concept is straightforward: by providing smokers with safer alternatives, we can reduce their exposure to harmful tobacco by-products. Traditional tobacco products, like cigarettes, produce thousands of harmful chemicals when burned, many of which are responsible for smoking-related diseases. Reduced-risk products, however, significantly lower the presence of these harmful chemicals, thus reducing health risks.

Snus: Research has shown that Snus can reduce the incidence of smoking-related diseases by up to 90 percent. This smokeless product bypasses the combustion process entirely, eliminating many of the harmful byproducts of burning tobacco.

HTPs: Heated tobacco products have been found to reduce harmful chemicals by up to 90 percent. By heating rather than burning tobacco, these products offer a much safer alternative to traditional cigarettes.

E-cigarettes: E-cigarettes, also known as ‘Vapes’, which vaporise a liquid solution containing pharmaceutical-grade nicotine (same as in Nicotine Replacement Therapy (NRT) products, have been shown to have at least a 95 percent reduced risk profile when compared with combustible cigarettes. The vapour produced by e-cigarettes contains far fewer harmful substances compared to cigarette smoke.

Oral nicotine pouches: They are a tobacco-free, oral nicotine product that uses a similar concept to snus. They contain nicotine, flavourings, and sweeteners, but no tobacco.

These pouches are designed to be placed between the upper lip and gum, where they dissolve slowly, releasing nicotine and flavour. They come in various flavours and nicotine levels, offering a convenient and discreet way to manage nicotine cravings without the harmful effects of tobacco.

The benefits of THR are numerous and profound, impacting both individual health and public health on a broader scale:

1. Reduced smoking-related deaths: By switching to Reduced-risk products, smokers can significantly reduce their risk of smoking-related diseases, such as lung cancer, heart disease, and chronic obstructive pulmonary disease (COPD).

2. Increased quit rates: Reduced-risk products have been shown to increase quit rates by up to 50 percent. Many smokers find these alternatives more acceptable and easier to transition to than quitting cold turkey.

3. No second-hand smoke: Most reduced-risk products eliminate second-hand smoke, protecting non-smokers from harmful tobacco products. This is especially important in densely populated areas where second-hand smoke exposure is a significant public health concern.

Nigeria, with nearly 30,000 tobacco-related deaths annually, has one of the highest smoking rates in Africa. The burden of tobacco-related diseases is substantial, straining the country’s healthcare system and impacting the well-being of its citizens. However, there is hope. By embracing Tobacco Harm Reduction (THR), Nigeria can reduce tobacco-related harm and improve the health of its population.

Introducing safer alternatives, such as e-cigarettes and heated tobacco products (HTPs), could provide Nigerian smokers with viable options to reduce their health risks. Education and awareness campaigns are essential to inform the public about these alternatives and their benefits. Policymakers must also create a supportive regulatory environment that encourages the adoption of reduced-risk products while ensuring their safety and efficacy.

Tobacco harm reduction is not a silver bullet, but it is a powerful tool in the fight against tobacco-related harm. By providing smokers with safer alternatives, we can reduce smoking-related diseases and deaths, improve public health, and protect non-smokers from second-hand smoke exposure. It’s time for policymakers, healthcare professionals, and the general public to recognize the potential of THR and work towards a safer future.

The success stories from Sweden and Japan clearly illustrate the substantial public health benefits of tobacco harm reduction (THR). By adapting and applying these successful strategies to fit local contexts, countries like Nigeria have a significant opportunity to reduce the detrimental effects of tobacco use. It is imperative that we unite in our efforts to eradicate tobacco-related harm and promote safer alternatives, paving the way for a healthier and brighter future for all.