Nigeria urged to develop tobacco harm reduction policy

Tobacco. Photo: The Sun Nigeria

Nigeria should develop an evidence-based policy on tobacco harm reduction as part of a broader strategy to reduce smoking-related disease and help adults who are unable or unwilling to quit nicotine entirely, Public Health Advocate and Lagos State Ministry of Health consultant Godswill Iboma has said.

Iboma declared that Nigeria was at a critical point in its response to tobacco use, arguing that the country’s existing tobacco-control measures should be complemented by a locally developed framework that considers emerging nicotine products and evolving international evidence on harm reduction.

His call comes as debate intensifies globally over the role of non-combustible nicotine products, including nicotine pouches, e-cigarettes and heated tobacco products, in tobacco-control strategies.

The central argument behind tobacco harm reduction is that adults who continue to smoke combustible cigarettes could potentially reduce their exposure to harmful substances by switching completely to alternatives that do not involve burning tobacco. Iboma stressed, however, that such products should not be presented as risk-free or as a substitute for preventing nicotine use and helping smokers quit.

“A credible harm-reduction framework should neither romanticise nicotine use nor stigmatise adults who choose not to quit,” Iboma wrote in a note shared with The PUNCH.

“Instead, it should provide smokers with accurate information about the relative risks of available products and enable them, in consultation with appropriate health professionals, to make informed decisions.”

Nigeria already has a national tobacco-control framework, with the Federal Government implementing measures under the National Tobacco Control Act and related regulations. Iboma said the next phase should focus on how Nigeria can incorporate emerging evidence without weakening protections against tobacco use, particularly among young people.

“Regulation should protect the public and young people in particular, prevent unintended initiation and address illicit or substandard products,” he said, adding that policymakers should also consider whether properly regulated alternatives could have a role for adult smokers.

The debate is taking place against a backdrop of competing views over how Nigeria should regulate newer nicotine products. Tobacco-control advocates have expressed concerns that greater availability of e-cigarettes, heated tobacco products and nicotine pouches could undermine existing safeguards and encourage nicotine use among young people.

The World Health Organization has also called on governments to apply strong controls to emerging nicotine products, while public-health advocates continue to debate whether some products could have a role in reducing the health risks associated with continued cigarette smoking.

Iboma said Nigeria should therefore avoid simply importing policies developed elsewhere.

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Countries including Sweden and Japan have become prominent reference points in the international debate. Sweden’s declining smoking prevalence has been discussed in connection with its long-term tobacco-control measures and the availability of smoke-free nicotine products, while Japan has recorded a significant shift in cigarette consumption following the introduction of heated tobacco products.

But Iboma said these experiences should be treated as evidence to study rather than templates for Nigeria to copy.

“Rather than directly replicating the approach of countries such as Sweden or Japan, Nigeria should assess the evidence against its own population, healthcare system and consumer realities,” he stated.

That would require more Nigerian research into patterns of nicotine use, the behaviour of smokers, the potential effects of switching products and the impact of regulation, he said.

Healthcare professionals would also need access to independent, peer-reviewed evidence and continuing education so they can discuss cessation and harm-reduction options with patients responsibly.

For policymakers, the challenge is to balance any potential role for lower-risk alternatives among adult smokers with measures designed to prevent youth uptake, protect non-smokers and maintain restrictions on tobacco marketing and promotion.

Iboma said the objective should remain measurable public-health outcomes: fewer smokers, lower exposure to harmful toxins among smokers and people exposed to second-hand smoke, and fewer smoking-related diseases.

“Tobacco harm reduction is not a replacement for tobacco control measures,” he said, describing it instead as an area of continuing scientific investigation within the broader response to smoking.

Nigeria’s tobacco debate is therefore moving beyond the question of whether smoking should be discouraged. It increasingly concerns how regulation, public-health policy and scientific evidence should respond to a market in which nicotine products are becoming more diverse.

For Iboma, that creates an opportunity for Nigeria to develop a policy tailored to its own public-health realities while maintaining cessation as the primary objective.

“Nigeria cannot afford to remain on the sidelines of the global tobacco harm reduction conversation,” he noted.