By Dr. Mercy Korir
NAIROBI, Kenya, July 5 – Nicotine use can be traced back to 12,300 years ago. Global tobacco trends show a decline, with 1.25 billion people still smoking. According to the World Health Organisation (WHO), 19 million stopped smoking two years ago which is a positive step. However, the demand for nicotine is persistent and unlikely to dissipate.
Nicotine consumption regulation should balance harm reduction, consumer protection, and
realistic expectations about human behaviour while facilitating informed consumer choice. Basic
safety standards are non-negotiable, and products must not contain harmful substances.
Regulation should provide consumers with accurate information and ensure transparent and
trustworthy manufacturing and marketing without stifling innovation. Regulating harm-reduction
products is simpler than perceived.
Attempts to curb nicotine use through prohibition or aggressive regulation have not only failed
but often exacerbated the problem. For instance, Australia’s stringent anti-nicotine policies have
not eradicated nicotine use; instead, they have driven it underground, creating a black market
fraught with unregulated and potentially hazardous products. The same has been observed in
India.
Regulation must be justified on its merits. Over-regulation can limit consumer choice and drive
people towards unregulated, potentially dangerous products. Therefore, regulatory measures
should be carefully evaluated for their effectiveness and unintended consequences.
Understanding consumer behaviour is the key to effective regulation. Consumers make choices
based on a variety of factors, including convenience, social influences, and product
satisfaction—not solely on health risks. Regulation should, therefore, address information
deficits, providing consumers with clear, truthful information about the relative risks and benefits
of different nicotine products.
Informed choice is not merely about access to information but also about ensuring the
information is understandable and actionable. Consumers are not experts in aerosol chemistry
or toxicology; they rely on regulators to set standards that ensure the safety and quality of the
products they use. The regulation of nicotine products, therefore, requires a balanced approach
that acknowledges the persistent demand for nicotine and the complex motivations behind its
use.
It is crucial to prioritize harm reduction and guide smokers toward safer alternatives. The WHO
acknowledges harm reduction as a principle but often favours prohibition over harm reduction,
which can lead to adverse consequences. Banning flavours and e-cigarettes may result in black
markets. Regulations should enable informed choices and ensure product safety without driving
consumers to unregulated markets.
The fear that children are taking up smoking new nicotine products due to the use of different
flavours in the product still does not justify prohibition. As argued earlier, harm reduction
products are much easier to regulate than invisible products which are sold underground.
Unregulated products in a black market are much more dangerous to consume and will still get
into the hands of children if parental oversight is present.
The debate over tobacco harm reduction and e-cigarettes is complicated by conflicting scientific
evidence, which can influence public opinion and policy decisions. E-cigarettes present risks,
especially for young people and non-smokers, but also offer a harm reduction tool for adult
smokers. Misunderstandings about nicotine and the misuse of data further complicate the issue.
Transparent research funding and rigorous peer review are essential to restoring trust in the
scientific process.
Moreover, the influence of vested interests cannot be overlooked. Industry-funded studies and
biased reporting have historically skewed perceptions, reinforcing the need for independent
replication and rigorous peer review. Transparency in research funding and disclosure of
conflicts of interest are essential to restoring credibility and trust in the scientific process.
Policy implications loom large in this arena. Flawed science can lead to regulations that harm
public health. Balancing youth protection with harm reduction for adult smokers requires
evidence-based policymaking grounded in comprehensive data.
Moving forward, we must champion a culture of skepticism and rigorous inquiry. Embracing
post-publication peer review and promoting interdisciplinary collaboration can fortify the integrity
of research in tobacco harm reduction. Empowering consumers with accurate information and
encouraging open dialogue between stakeholders will foster a more nuanced public discourse,
free from the distortions of bad science.
Effective tobacco harm reduction policy demands a commitment to evidence, ethics, and
empathy. By prioritising public health and scientific integrity, we can navigate the complexities of
vaping with clarity and compassion, forging a future where informed choices lead to healthier
communities.
Moving beyond the binary of prohibition versus unregulated markets, thoughtful, evidence-
based regulation can protect public health, empower consumers, and accommodate human
behaviour. Embracing a nuanced regulatory framework allows us to better navigate nicotine
consumption and create a healthier, more informed society.
The author is a Medical Doctor and Journalist
