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Proliferation of oral nicotine products enhancing access to minors

Health experts have raised the red flag over proliferation of oral nicotine products in the Kenyan market which they warn has made them easily accessible to school children and the youth, thus leading to addiction and consequently smoking and use of other drugs.

Deputy Director in charge of Administration and Planning at Nakuru County Department of Health Dr Joy Mugambi expressed concern that innovations in the tobacco industry have led to the introduction of new liquid nicotine products such as vapes, vaporizers, vape pens, and e-pipes which she said can cause as much damage as traditional tobacco products.

“In recent years, there has been an increase in production of new tobacco products beyond e-cigarettes which have been used as a substitute for conventional cigarettes. The design of these products makes them easily accessible to minors. Young people have been drawn to the new cigarette alternatives. These products continue to negatively affect the health of our citizens,” Dr Mugambi said.

She stated that due to sustained anti-tobacco use campaigns and tightened regulations on manufacture and marketing of tobacco products, concerned local and multinational firms were now promoting non-combustible nicotine products as safer alternatives to cigarette smoking.

“Nicotine is a highly addictive substance that causes feelings of temporary relaxation and stress relief when inhaled. There are more than 250 flavours of nicotine circulating in the Kenyan market, some taste like chewing gum. These flavours, colours of packaging and concealed mode of consumption are all meant to win customers particularly teenagers,” Dr. Mugambi said.

The World Health Organization (WHO) says that the global shift by tobacco processors to the flavoured, sleek design products is a ploy to capture the younger generation market.

Dr Mugambi who spoke when the County launched an anti-tobacco use campaign dubbed ‘Towards a Tobacco and Nicotine free Nation’ said compared to regular cigarettes, whose health effects have been studied extensively over many years, studies on the impacts of e-cigarettes and oral nicotine products are still limited as it is only recently that the products gained popularity.

“Our position as a department of health remains that all tobacco products are harmful and we dissuade people from using them. The Treasury’s proposal to change the taxation regime for liquid nicotine to Sh70 per milliliter is a step in the right direction as the regulation is meant to constrain access and consumption of the new form of tobacco which is popular among young people,” noted the Deputy Director.

E-cigarettes are banned in countries such as India, Brazil, Uruguay and Singapore. Due to dipping cigarette sales and reduction of smoking globally, local firms are shifting their attention to nicotine pouches and similar products.

Nicotine pouches which retail at a similar price point to cigarettes contain fibres from pine trees, eucalyptus, nicotine, and flavouring agents and are marketed as a safer alternative for smoking addicts who want to quit the habit.

Last year, Health CS Mutahi Kagwe accused the Pharmacy and Poisons Board of flouting tobacco control laws when it licensed the sale of the pouches, and subsequently demanded the regulator provide the ministry with a comprehensive report on the criteria used and circumstances leading to the registration and licensing of the product. The Health ministry subsequently declared them illegal.

“What we were in opposition to is the terms they were operating under. We want to classify it appropriately as a tobacco product,” Mr Kagwe said.

The nicotine pouches are placed under the lip so that the nicotine can be absorbed by the body, but they do not contain tobacco. The government has since banned nicotine pouches.

Dr Mugambi singled out tobacco use and exposure to its smoke as the leading causes of preventable deaths globally, causing seven million deaths every year.

She said that tobacco accounts for 53 per cent of mortality in Kenya, with a recent survey estimating that the country has 2.5 million adult tobacco users and 14 per cent of Kenyans exposed to second hand tobacco smoke at home.

The Deputy Director also said that 10 per cent of Kenyan youth aged 13 to 15 years are regular consumers of tobacco products.

She added, “Of concern is the rising burden of non-communicable diseases (NCDs) in the country which are caused mainly by four risk factors, tobacco being one of them,”

County Public Health officer Ms Angela Lelei noted that on average, 80 per cent of premature deaths are related to the use or exposure to tobacco smoke, adding that this increased Kenya’s challenges to achieving its development goals.

Ms Lelei said that more than 50 per cent of hospital admissions in Kenya are due to NCDs, with tobacco as a leading factor.

She stated that tobacco use costs economies enormously through increased healthcare costs as well as decreased productivity as it worsens health inequalities while intensifying poverty as the poorest people end up spending less on essentials such as food, education and healthcare.

Ms Lelei added, “While the number of smokers has been dropping significantly in developed countries, the scenario is not encouraging across Africa, where prevalence increased in 23 countries in the 2000-2012 period,’

Tobacco regulations in Kenya have been stricter over the years including the disputed regulations requiring cigarette manufacturers to include large graphic and text health warnings, mandatory disclosures of tobacco product ingredients and revenues, smoke-free environments in public places and adjacent streets, walkways and verandahs, as well as limit interactions between the tobacco industry and public officials.

The law also requires tobacco companies to pay damages for harm suffered known as solatium compensation contribution of two per cent of the value of the products manufactured or imported to fund tobacco control research, cessation and rehabilitation programmes.

Cigarette manufacturers had challenged the law and lost the appeal after the Supreme Court ruled that neither was there discrimination nor unconstitutionality when the disputed regulations were made as well as came into force.

By Anne Mwale and Kelvin Kamau

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