Africa stands at a turning point in its public health journey. As smoking rates rise, the policy response remains trapped in outdated ideologies that prioritise prohibition over science. Global tobacco control efforts still focus on abstinence, yet ignore a critical, evidence-based tool in the fight against tobacco-related disease, smoke-free alternatives.
The science is clear: the real danger of tobacco lies in combustion. Burning tobacco releases thousands of toxic chemicals that cause cancer, heart disease, and respiratory illness.
Smoke-free products such as e-cigarettes and heated tobacco significantly reduce exposure to these toxins. Yet many African governments continue to treat all nicotine products as equally harmful, a stance that is both scientifically flawed and ethically indefensible.
Although the age-standardised prevalence of smoking in Africa stands at 18 percent for men and 2 percent for women, population growth means the total number of smokers keeps increasing, from 52 million in 2000 to 66 million in 2015, and an expected 84 million by 2025.
Tobacco companies view the continent as a growth frontier due to its youthful population and weak regulation. Meanwhile, national laws remain inconsistent and poorly enforced.
Kenya offers a case study in this tension. The Harm Reduction Bill 2025 was a landmark move, recognising the value of pragmatic and inclusive health interventions. It affirmed that public health policy must be guided by science, not stigma. Yet subsequent regulations on nicotine alternatives have tightened, citing youth addiction concerns.
While precaution is valid, over-regulation risks sidelining products that could help millions of smokers transition away from combustible tobacco, the most lethal form of nicotine consumption.
In Kenya, about 2.6 million adults (7.6 percent) smoke, and tobacco use accounts for roughly 9,400 deaths annually. Despite this toll, recent surveys show overwhelming public support for safer alternatives.
Research by the Campaign for Safer Alternatives (CASA) found that 83 percent of Kenyans back tobacco harm reduction policies, 85 percent believe safer products help smokers quit, and 73 percent fear bans will fuel black-market sales.
These findings underscore a public eager for evidence-based policies and safer consumer choices.
Contrast this with South Africa, which has opted for a more balanced approach. The ongoing debate on the Tobacco Products and Electronic Delivery Systems Control Bill reflects an effort to regulate without banning. The country seeks to safeguard public health while acknowledging harm reduction’s role in curbing smoking-related disease.
With adult smoking at 20.3 percent and 32,000 annual tobacco-related deaths, about 920,000 South Africans now use innovative smoke free products, evidence that alternatives already play a role in transition.
Studies estimate that integrating smoke-free alternatives into tobacco control strategies in Kenya and Nigeria could save up to 600,000 lives by 2060, easing healthcare costs and boosting productivity.
Yet across Africa, regulatory frameworks for safer nicotine products remain fragmented: e-cigarettes are unregulated in about 38 countries, and heated tobacco products in roughly 44. This vacuum leaves millions of smokers without access to potentially life-saving options.
The divide between Kenya’s cautious stance and South Africa’s pragmatic one captures Africa’s broader dilemma: whether to regulate new nicotine products through fear or to embrace harm reduction as a science-driven, public-health necessity.
The stakes are high. Tobacco use is growing among youth and low-income groups, and without adaptive policies, Africa risks entrenching outdated frameworks that fail to protect its people.
Millions of smokers cannot quit nicotine overnight. Denying them safer alternatives is not only ineffective, it is unethical. Harm reduction embodies a fundamental human right: access to accurate information and informed choice.
As the 11th Conference of the Parties (COP11) approaches, African leaders have a rare opportunity to shape global tobacco policy. Kenya’s Harm Reduction Bill offers a foundation; South Africa’s regulatory path provides balance. Other nations should follow their lead.
This is Africa’s defining moment. The continent can either cling to moralistic resistance or embrace pragmatic, life-saving solutions. Ignoring smoke-free alternatives is a costly gamble. Choosing harm reduction, grounded in compassion and science, can pave the way for a healthier and more equitable future.
Africa stands at a turning point in its public health journey. As smoking rates rise, the policy response remains trapped in outdated ideologies that prioritise prohibition over science. Global tobacco control efforts still focus on abstinence, yet ignore a critical, evidence-based tool in the fight against tobacco-related disease, smoke-free alternatives.
The science is clear: the real danger of tobacco lies in combustion. Burning tobacco releases thousands of toxic chemicals that cause cancer, heart disease, and respiratory illness.
Smoke-free products such as e-cigarettes and heated tobacco significantly reduce exposure to these toxins. Yet many African governments continue to treat all nicotine products as equally harmful, a stance that is both scientifically flawed and ethically indefensible.
Although the age-standardised prevalence of smoking in Africa stands at 18 percent for men and 2 percent for women, population growth means the total number of smokers keeps increasing, from 52 million in 2000 to 66 million in 2015, and an expected 84 million by 2025. Tobacco companies view the continent as a growth frontier due to its youthful population and weak regulation.
Meanwhile, national laws remain inconsistent and poorly enforced.
Kenya offers a case study in this tension. The Harm Reduction Bill 2025 was a landmark move, recognising the value of pragmatic and inclusive health interventions. It affirmed that public health policy must be guided by science, not stigma. Yet subsequent regulations on nicotine alternatives have tightened, citing youth addiction concerns.
While precaution is valid, over-regulation risks sidelining products that could help millions of smokers transition away from combustible tobacco, the most lethal form of nicotine consumption.
In Kenya, about 2.6 million adults (7.6 percent) smoke, and tobacco use accounts for roughly 9,400 deaths annually. Despite this toll, recent surveys show overwhelming public support for safer alternatives. Research by the Campaign for Safer Alternatives (CASA) found that 83 percent of Kenyans back tobacco harm reduction policies, 85 percent believe safer products help smokers quit, and 73 percent fear bans will fuel black-market sales.
These findings underscore a public eager for evidence-based policies and safer consumer choices.
Contrast this with South Africa, which has opted for a more balanced approach. The ongoing debate on the Tobacco Products and Electronic Delivery Systems Control Bill reflects an effort to regulate without banning.
The country seeks to safeguard public health while acknowledging harm reduction’s role in curbing smoking-related disease. With adult smoking at 20.3 percent and 32,000 annual tobacco-related deaths, about 920,000 South Africans now use innovative smoke free products, evidence that alternatives already play a role in transition.
Studies estimate that integrating smoke-free alternatives into tobacco control strategies in Kenya and Nigeria could save up to 600,000 lives by 2060, easing healthcare costs and boosting productivity.
Yet across Africa, regulatory frameworks for safer nicotine products remain fragmented: e-cigarettes are unregulated in about 38 countries, and heated tobacco products in roughly 44. This vacuum leaves millions of smokers without access to potentially life-saving options.
The divide between Kenya’s cautious stance and South Africa’s pragmatic one captures Africa’s broader dilemma: whether to regulate new nicotine products through fear or to embrace harm reduction as a science-driven, public-health necessity.
The stakes are high. Tobacco use is growing among youth and low-income groups, and without adaptive policies, Africa risks entrenching outdated frameworks that fail to protect its people.
Millions of smokers cannot quit nicotine overnight. Denying them safer alternatives is not only ineffective, it is unethical. Harm reduction embodies a fundamental human right: access to accurate information and informed choice.
As the 11th Conference of the Parties (COP11) approaches, African leaders have a rare opportunity to shape global tobacco policy. Kenya’s Harm Reduction Bill offers a foundation; South Africa’s regulatory path provides balance. Other nations should follow their lead.
This is Africa’s defining moment. The continent can either cling to moralistic resistance or embrace pragmatic, life-saving solutions. Ignoring smoke-free alternatives is a costly gamble. Choosing harm reduction, grounded in compassion and science, can pave the way for a healthier and more equitable future.
