Last week on Thursday, the National Cancer Institute of Kenya (NCI-K), based at the Ministry of Health, released a report showing the growing cancer burden in Kenya. NCI Acting Chief Executive Officer Dr Alfred Karagu, who appeared before National Assembly’s Health Committee chaired by Hon. Sabina Chege noted that overall, cancer kills 33,000 Kenyans every year. The leading is oesophagal cancer, which kills nearly everyone who contracts it in Kenya. According to NCI-K, 4,380 people are diagnosed with oesophagal cancer annually, and at least 4,351 die every year, meaning only 29 survive. But they live with crippling post-operative complications.

Cigarette smoking is an important risk factor for oesophagal cancer and is the most important preventable cause of many cancers and cardiovascular diseases overall.

Over the years, Kenya has made important steps in reducing the burden of cancer, by helping thousands of people quit tobacco and other nicotine-based products that cause harm. It’s for this reason Kenya became a party to the WHO Framework Convention on Tobacco Control on February 27, 2005.

The percentage of Kenyans aged over 15 years who use tobacco products has declined marginally from nine per cent in 2012 to eight per cent in 2017, according to the 2018 National Authority for the Campaign against Alcohol and Drug Abuse (NACADA) study.

This means that about 2.2 million Kenyans still use tobacco products.

And now, while the country and indeed the world is struggling to control the burden of cancers and the growing burden of NCDs in total, British American Tobacco (BAT-Kenya) last week announced it will introduce in Kenya an array of nicotine-based products.

The company’s Managing Director Beverly Spencer made this announcement when she released the BAT’s Half Year 2019 results on July 19, 2019. He claimed the products, mainly ‘nicotine pouches’, could reduce the risks associated with passive smoking.

According to the company, the nicotine pouch is a non-tobacco, whitish product that users place under their lip and the nicotine is then absorbed through their gum. The company claims it has reduced risks, compared to cigarettes, but it has not publicly produced adequate data to show nicotine pouches are a less risky alternative to cigarettes. In any case, why should Kenyans be subjected to harmful products, merely because they are “less-harmful”?

We call upon Kenyan government not to license these products that are increasingly complex threats to public health, for several reasons.

First, we also refer to the latest WHO Report on the Global Tobacco Epidemic 2019, released on Friday 26th July 2019.

The World Health Organisation makes clear that it does not endorse these products, especially for smoking cessation and argues that at a minimum, these products should be subject to policies that have proven effective in reducing tobacco use, including plain packaging and bans on flavourings.

The possibility of tobacco industry interference in tobacco cessation efforts through misinformation about the potential benefits of these products – which are presented as alternatives but in most cases are complementary to the use of conventional tobacco products – is a present and real threat

https://www.who.int/news-room/detail/26-07-2019-who-launches-new-report-on-the-global-tobacco-epidemic

The report further states that there are real concerns about the risk these products pose to non-smokers who start to use them, especially young people. Unlike to tried and tested nicotine and non-nicotine pharmacotherapies that are known to help people quit tobacco use, WHO does not endorse -cigarettes as cessation aids.

We believe tobacco companies are using the introduction of these products in public relations campaigns to portray themselves as part of the solution to the global tobacco epidemic when in fact their main business is still to sell cigarettes, which are known to kill over 30,000 Kenyans annually.

According to BAT itself, the following health risks are associated with nicotine:

• Foetal nicotine exposure may lead to adverse postnatal health consequences and both foetal and adolescent nicotine exposure may lead to adverse effects on cognitive function and this could to lasting adverse consequences for brain development.
• There are also studies that suggest that smoking in adolescence is associated with cognitive and attentional impairments in later life, and possibly to an increased risk of mental health problems, most likely related to nicotine exposure.
• Nicotine is implicated in the development of insulin resistance and irregularities in glucose metabolism which could aggravate diabetes.
• Nicotine exposure can increase adverse events in people with unstable heart conditions or severe hypertension.

Last year, the US Food and Drugs Administration found some of BAT’s smokeless products to have extremely harmful chemicals. For instance, Snus, another smokeless, nicotine delivery product, contains higher amounts of arsenic, cadmium and nicotine.

These levels may result in increased user exposures to carcinogens and other toxicants that may subsequently increase the risk for cancer, heart disease and reproductive or developmental effects

Further, there is no evidence that BAT’s new nicotine delivery products will lower the number of smokers in Kenya. Since the products can be used discreetly, they may also appeal to teenagers, who will live with the effects of nicotine addiction and other health effects.

This will particularly lead young people to take up more harmful forms of nicotine or tobacco consumption.