Harm reduction initiatives offer hope for low income smokers
On a normal day, Justice Zimba, 44, and Chawezi Chisambi, 30, both of Group Village Head Zebera in the rural Mzimba district in Malawi, smoke 50 cigarettes of chingambwe (unprocessed tobacco) per day, loosely translating into 2.08 cigarettes per hour.
But Zimba and Chisambi disclose this figure could increase when and where they are sharing a gourd of masese (opaque beer) or a bottle of locally distilled spirit (kachaso) thereby exposing themselves to higher risks of developing lung cancer.
“Beer goes hand in hand with cigarettes. The more we drink, the more we smoke; hence, when we are drinking, we smoke as many cigarettes as we can,” said Chisambi.
By the time of the telephone interview at 6:55am on Monday morning on December 12, 2022, Chisambi said he had already smoked eight cigarettes of unprocessed tobacco as he made ridges on his small farmland in Loti Chisambi Village.
A recent study by Dr. Nina Thomas showed that while all cigarettes are bad as they all increase the risk for lung cancer and the risk of dying from lung cancer, unfiltered cigarettes have the highest risk of any type of cigarette.
“People who smoke unfiltered cigarettes have double the risk of lung cancer death that other smokers do. And smoking unfiltered cigarettes was also linked to a 30 percent higher risk of dying from any cause,” Thomas established.
The findings of the study say smoke from all cigarettes, natural or otherwise, has many chemicals that can cause cancer (carcinogens) and toxins that come from burning the tobacco itself, including tar and carbon monoxide.
It adds that even herbal cigarettes with no tobacco give off tar, particulates, and carbon monoxide and are dangerous to one’s health.
Both Zimba and Chisambi acknowledge the danger they are exposing themselves to by smoking unfiltered (unprocessed) tobacco.
“We smoke chingambwe because we cannot afford processed cigarettes. Otherwise, we could have switched to processed ones to reduce the risk,” said Zimba in a separate interview.
But there is a ray of hope for the low income earning smokers. At the 2022 Harm Reduction Exchange Conference in Nairobi, Kenya, recently, speakers disclosed that cigarette smokers will now have a plethora of products available to them in an effort to reduce the harm caused by smoking.
Such products include e-cigarettes, nicotine patches, and chewing gums, which were developed to reduce the harm caused by cigarette smoking.
The conference was held under the theme ‘Harm Reduction: Making a Difference in Africa’.
Internationally recognized and award-winning oncologist and professor of Surgery at Senegal’s Cancer Institute, Prof Abdoul Kassé, disclosed that traditional cessation and smoking prevention norms are not the only ways available to smokers who are not ready to quit.
“These innovative harm reduction initiatives will save the lives of more Africans. Harm Reduction is a powerful public health tool with the potential to reduce cancer and should be at the heart of all public health development strategies,” said Kassé.
Stakeholders have cited lack of awareness and sensitization about the availability and benefits of alternative, potentially lower-risk products to cigarettes as one of the reasons for the slow progress in implementing harm reduction programmes in African.
It is against this background that during the conference, Principal of Integra Africa, Dr. Tendai Mhizha, implored journalists and media houses across the continent to take a leading role in disseminating accurate information about tobacco harm reduction initiatives.
Mhizha observed there has been a lot of disinformation and misinformation about nicotine and the alleged negative effects of e-cigarettes on public health, resulting in risk-reducing policies and narratives that deny their benefits.
“The media bears the difficult responsibility of combating the scourge of disinformation and misinformation on harm reduction, as well as other socio-political stances that are prescriptive and do not support consumers’ right to healthier lifestyle choices. Journalists are therefore key in tackling misinformation and disinformation in the tobacco harm reduction discourse, which is perpetuating death and diseases from smoking combustible cigarettes,” said Mhizha.
On her part, Dr. Vivian Manyeki of Kenya said tobacco harm reduction has a strong scientific and medical foundation, and it holds great promise as a public health measure to help millions of smokers.
However, Manyeki observed that many smokers are unable, or unwilling, to quit through complete nicotine and tobacco abstinence.
“They continue to smoke despite the very real and obvious negative health consequences, as well as the numerous public health campaigns. Traditional smoking cessation proposals should be supplemented with alternative but more realistic options such as Harm Reduction,” she said.
Panelists to the conference included Ms Bernice Opondi, Joseph Magero, Jonathan Fell, Chimwemwe Ngoma, Clive Bates, and Dr Kgosi Letlape, among others, while journalists came from 15 African countries, which include Kenya, Eswatini, Nigeria, Botswana, Ethiopia, Lesotho, Malawi, Mozambique, Namibia, Rwanda, Tanzania, Uganda, South Africa, Zambia, and Zimbabwe.
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