By Esther Onyegbula

Thousands of lives could be saved annually in Nigeria if the country adopts a science-based tobacco harm reduction (THR) strategy, according to a new report that is sparking urgent calls for reform in national tobacco control policies.

The Lives Saved Report: Nigeria & Kenya, released this week by global public health researchers, warns that Nigeria’s current reliance on traditional anti-smoking measures, such as taxation, advertising bans, and public smoking restrictions, does not adequately support adult smokers who are unable to quit. The report advocates for integrating harm reduction strategies, including the use of less harmful alternatives like e-cigarettes, heated tobacco, and nicotine pouches.

“Tax and bans alone are not enough,” said Yussuff Adebayo, Global Director for Research and Thought Leadership at Global Health Focus. “We need to give adult smokers realistic and safer exit ramps away from deadly cigarettes. That’s where harm reduction comes in.”

Although Nigeria has recorded a steady decline in smoking prevalence, tobacco-related illnesses continue to place a heavy toll on the nation’s health system. Experts argue that failure to incorporate THR into national policy may stall progress and cost lives unnecessarily.

The report outlines that non-combustible nicotine alternatives are significantly less harmful than conventional cigarettes, largely because they avoid the combustion process that releases most of tobacco’s toxic chemicals. It calls on Nigerian regulators to adopt a risk-proportionate framework that clearly distinguishes between combustible and non-combustible products, an approach already being used in countries like Sweden and the UK.

Sweden, which aggressively promotes harm reduction tools, is on track to become the world’s first smoke-free country, with smoking rates dipping below 5%. By contrast, Nigeria risks falling behind due to limited public awareness, regulatory inertia, and misinformation that conflates harm reduction products with traditional smoking.

“Many Nigerians think e-cigarettes are just as harmful as cigarettes. That’s simply not true, and that misinformation is killing people,” Adebayo said.

The report criticizes the World Health Organization’s MPOWER framework, widely adopted by Nigeria, for not explicitly including harm reduction, even though the WHO’s broader Framework Convention on Tobacco Control (FCTC) allows for it. This omission, the report argues, has discouraged innovation in tobacco control strategies across Africa.

In addition to policy changes, the report calls for a multi-sectoral response involving universities, public health institutions, and civil society groups to generate local data, debunk myths, and educate the public on safer nicotine alternatives.

The economic implications are also significant. Tobacco-related diseases cost Nigeria billions annually in healthcare spending and lost productivity. Advocates say THR could reduce this burden by lowering preventable hospital admissions and long-term treatment needs.

While Nigeria has not formally embraced THR, early signs of interest are emerging. Some advocacy groups and private health institutions are organizing public forums and expert panels to explore the approach. However, national-level adoption remains elusive.

“Progress is slow, but there is momentum,” said Adebayo. “Nigeria must act now before more lives are lost to outdated and incomplete tobacco control models.”

With over 16,000 tobacco-related deaths annually in Nigeria, the report concludes with a stark warning: “Bold leadership and smart policy are urgently needed. The evidence is clear, harm reduction saves lives.”