Tobacco harm reduction activists are urging the government to revise the Tobacco Control Act to incorporate the harm reduction principle. Tobacco harm reduction is a public health strategy that is about minimizing the negative health impact of smoking.
A harm reduction strategy for smokers includes recommending the use of alternative nicotine delivery products such as e-cigarettes, smokeless tobacco or new heated tobacco products to smokers instead of conventional cigarettes.
The basic proposition of harm reduction is not that alternative nicotine products are harmless but that they offer reductions in risk of 95%.
Tobacco use if not stopped can be the cause of death in 50% of its users according to the World Health Organisation. The consumption of tobacco products and its harmful effects affect both smokers and non-smokers and is a major risk factor for six of the eight leading causes of death in the world.
Tobacco harm reduction refers to switching to a less harmful nicotine product for those who are not able to quit smoking or nicotine use. Nicotine is the main reason people continue to smoke but it has relatively minor health effects, except in pregnancy. The focus is on preventing harm and not on preventing the use of nicotine itself.
Joshua Omunuk, a tobacco harm reduction activist, highlighted these concerns while speaking to journalists at the Nicotine Summit in Kampala.
Omunuk acknowledged that the 2015 Tobacco Control Act has made strides by addressing various societal challenges related to smoking.
However, he criticized the law for failing to provide solutions for smokers, those who wish to quit, and individuals seeking alternatives to smoking.
According to Omunuk, the current law primarily benefits non-smokers and those who oppose smoking but neglects the needs of tobacco users.
The Tobacco Control Act prohibits smoking in public places, workplaces, and public transport, and also bans tobacco advertising, promotion, and sponsorship.
Joel Sawa, another activist, emphasized that aligning with international best practices could help Uganda tackle the issues associated with tobacco use more effectively. He called for a robust national educational campaign to inform the public about the benefits of tobacco harm reduction and the availability of low-risk nicotine alternatives.
Sawa also stressed the need to provide smokers with clear, evidence-based information to support their transition away from harmful tobacco use.
A survey conducted by Tobacco Harm Reduction Uganda in Lira District in January 2022 and Bukedea District in 2023 revealed that 75% of oral cancer patients had a history of smoking, with quitting or dying being their only option. The survey also found that the average age of smoking initiation is 13 years, and 90% of smokers felt the current law did not help them quit.
Nathan Emong from Bukedea, who has successfully quit smoking, shared his experience of smoking for seven years before deciding to stop. He described frequent illnesses and chest pain as motivating factors for his decision to quit.
Emong used to smoke 8 to 10 cigarettes daily while socializing at bars. Now, one year smoke-free, he advocates for government action to help his friends and others stop smoking.
Omunuk proposed that the government should address smoking addiction similarly to drug addiction, suggesting that the current quit-smoking initiatives have not been effective for many individuals.
He argued for more empathetic solutions to help addicted smokers overcome their addiction and emphasized that the current approach needs to be re-evaluated.
There is a piece of strong evidence that smokers who used e-cigarettes in combination with in-person counseling were twice as likely to quit as those who used other nicotine replacement products.
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