Rejoinder: No Smoke, Less Harm: Sustaining Ghana’s Economy Through Tobacco Harm Reduction Strategy

The Vision for Accelerated Sustainable Development, Vision for Alternative Development, and Ghana NCD Alliance among other CSOs strongly reject the push by the Institute for Liberty and Policy Innovation (ILAPI), an ally of the tobacco industry for consistently promoting tobacco use, particularly among young people through its so-called harm reduction strategies, which has in recent time increased the demand of e-cigarettes and vaping products, containing nicotine and other harmful chemicals. While harm reduction may seem to offer a short-term solution to the dangers posed by combustible cigarettes, the recent World Health Organization (WHO) report on e-cigarettes cautions against such approaches. Meanwhile, ILAPI has continuously trumpeted the tobacco industry’s deadly products to children and young people in Ghana.

WHO emphasizes in the report dubbed Call to Action on Electronic Cigarettes urging governments to be wary of the harm associated with electronic cigarettes. We have drawn the attention of the Ministry of Health (and the Food and Drugs Authority to this report, but its recommendations are yet to be reflected in policy actions. It noted that nicotine, regardless of its form, is highly addictive and harmful, posing significant health risks. In addition, these so-called harm-reduction products typically contain additives, flavors, and chemicals that are dangerous to people’s health.

Strategies that replace one harmful product with another only maintain addiction and present long-term public health risks.

The Swedish approach which uses nicotine products like snus to reduce smoking-related diseases is often cited as a model. However, it should not be applied directly to Ghana’s context without scrutiny. Sweden’s success is embedded in its unique social and regulatory environment, which does not align with Ghana’s public health priorities and tobacco use patterns. While some stakeholders may present this approach as evidence of progress, it is essential to critically assess the benefits and limitations. Ghana has already achieved substantial progress in tobacco control through legislative frameworks, public education, and rigorous enforcement.

Currently, the smoking prevalence in Ghana is less than 5 percent with an upsurge in the use of e-cigarettes among young people, which attests to the fact that many of the users of these new trends are non-smokers, but have been influenced by the marketing tactics and appealing nature of the products. It is important to note that a non-smoker who uses these products may become addicted to nicotine and find it difficult to stop using them or become addicted to conventional tobacco products. This is what is being experienced in some parts of the country where young people are diverting to combustible cigarette use due to the unavailability of e-cigarettes at the time of need.

Furthermore, many e-cigarettes are designed to allow the control of nicotine (which can reach dangerously high levels). This can also increase the levels of other toxicants to the user and expose bystanders to harmful emissions.

Research also reveals that e-cigarette companies including British American Tobacco are increasingly targeting youth, employing aggressive marketing tactics using various channels that frame vaping as a safe alternative.

The Institute for Liberty and Policy Innovation, a strategic ally of the tobacco industry receiving funding from them through the Atlas Network to lobby on behalf of the industry, has publicly advocated for harm reduction strategies, stating that the industry wants to be part of the solution.” We believe such claims are intended to safeguard the industry’s viability and future profits. Our position is clear: the promotion of harm reduction strategies is a tactic to prolong business interests against safeguarding public health.

The belief that e-cigarettes are less harmful because they do not produce tobacco smoke creates a false sense of security. The World Health Federation policy brief on e-cigarettes provides further insights into these risks, underscoring the urgent need for stricter regulations to prevent the normalization of these dangerous products.

The comparison between harm reduction strategies in tobacco control and the use of condoms to prevent HIV transmission is misleading. While condoms effectively prevent disease transmission, nicotine alternatives sustain addiction which causes severe health problems. Research shows that nicotine impacts mental health, and since human brain development continues until around age 25, young users are particularly vulnerable to its harmful effects. Harm reduction strategies fail to address these developmental and health challenges, exposing users to issues.

Is ILAPI aware that the target of the tobacco industry is children and young people? We want to know the interest and motive of the ILAPI, why are they not supporting or advocating for proven measures such as pictorial health warnings on tobacco packages, the ban of single sticks of tobacco products, an increase in taxes on tobacco products, etc.? CSO actors call on all stakeholders to prioritize the health of Ghanaians by rejecting the so-called harm reduction strategies, instead fully implementing the provisions of the WHO FCTC. We urge the MoH and FDA to resist pressures from industry-backed groups and remain focused on creating a tobacco-free future. Together, we can strengthen tobacco control policies and promote public health without compromising the gains we have made.

Issued by:

Labram M. Musah

Executive Director, Vision for Accelerated Sustainable Development/

National Coordinator, Ghana NCD Alliance 

Contact: 0243211854

Email: [email protected]