Profound Problem of Misinformation on Nicotine for Health Practitioners in Africa

“Alarmingly high” number of African doctors thinks nicotine causes cancer. Something that’s clearly needed in a continent with around a quarter million deaths each year caused by smoking tobacco, not by nicotine itself: the prioritization of health provider education in this area. It is paramount for physicians to understand the relative harm between nicotine and the other 7,000 toxins in tobacco smoke. This is especially important as physicians play a key role in recommending and prescribing nicotine replacement medications.

Cigarette smoking and the many chemicals it exposes a person to, not nicotine itself, presents the highest risk. According to Cancer research UK , nicotine is addictive but does not cause cancer. Most damage to health caused by smoking is due to tar. Researchers from U.K. National Institute for Health and Care Excellence (NICE) stated that “…it is primarily the toxins and carcinogens in tobacco smoke — not the nicotine — that cause illness and death.” In fact, other chemicals in smoke, such as benzo[a]pyrene, tobacco-specific nitrosamines, and benzene, are the primary causes of smoking-related diseases.

80% of smokers live in low-and middle-income countries and have no access to safer nicotine products — resulting in greater pain and suffering, prolonged illness and preventable deaths. Health professionals in Africa find themselves confronted by a phenomenon of rising cigarette smoking rates. Despite some effort by African governments in achieving some of the Sustainable Development Goals, reducing tobacco smoking has proved the hardest to deliver.

Nicotine does not cause cancer, but dozens of other chemicals found in tobacco products do. There are 4,000 chemicals in every cigarette. People smoke because they are addicted to the nicotine, but they are getting 3,999 other chemicals, too. Two hundred of those chemicals are poisonous and 43 are known carcinogens.

We need targeted strategic approaches to really start getting corrective information to the misinformed. The public-awareness implications apply not only to nicotine patches and gums, but to nicotine vapes and pouches, which research has found to be the more effective quit-smoking tools. Health practitioners have to get the information into hands in an understandable way, in a compelling way, so that smokers can make informed decisions. Policies must decouple nicotine from the harms caused by cigarette combustion.

Tobacco harm reduction is one of the most important public health policies today. Without greater clarity and differentiation of nicotine with robust scientific evidence as its foundation, we will struggle more than we should to realize its full potential

Smoking rates have declined to historically low levels in high-income countries, which may be attributed to favorable regulation when it comes to safer nicotine alternatives. Since this cigarette consumption rate has been on the decline in high income countries, it would seem logical to consider what has caused that decline. Studies have found that in most high-income countries the main drivers of reduced cigarette smoking rates have been the availability of cessation assistance for those who wish to quit smoking. The demand for conventional cigarettes has fallen as a result of smokers switching to less harmful nicotine products, such as snus, nicotine pouches, heating products and electronic cigarettes.

By Joseph Magero. Chair, Campaign for Safer Alternatives