By Esther Onyegbula

A public health expert has called on the Federal Government to adopt a pragmatic, science-driven Tobacco Harm Reduction (THR) framework to curb smoking-related diseases, insisting that Nigeria cannot rely solely on traditional tobacco control measures to protect adult smokers who are unable or unwilling to quit.

Dr. Yusuff Adebayo, a pharmacist, epidemiologist, and health systems researcher, made the appeal in a new commentary where he argued that THR offers the country a “realistic, evidence-based pathway” to reducing tobacco-related illnesses by providing safer nicotine alternatives.

Quoting the World Health Organization’s Global Adult Tobacco Survey (GATS 2023), which shows that 3.7 per cent of Nigerian adults currently smoke, Adebayo said the data underscores the need for a broader public health strategy that recognises the behavioural realities of nicotine use.

He noted that while cessation remains the best option for smokers, global evidence demonstrates that a significant number of adults are unable to quit, creating the need for policies that encourage switching from combustible cigarettes to scientifically validated lower-risk products.

“Decades of global tobacco control efforts have shown one clear reality: a segment of adult smokers will continue to seek nicotine. The goal should be to encourage them toward less harmful, scientifically substantiated products,” he said.

Citing international research, Adebayo referenced a 2022 Public Health England review which found vaping to be at least 95 per cent less harmful than smoking, largely because it eliminates smoke and tar—the primary drivers of tobacco-related disease. He also pointed to U.S. Food and Drug Administration (FDA) authorisations of certain heated tobacco and oral nicotine alternatives as Modified Risk Tobacco Products, following evidence that they expose users to significantly fewer toxicants.

According to him, Nigeria stands to benefit from a risk-proportionate regulatory system that differentiates between combustible cigarettes and non-combustible nicotine products, while ensuring product safety, quality, labelling, and responsible marketing.

“For THR to work in Nigeria, we need clear regulations, strong safety standards, transparent labelling, and fiscal policies that reflect relative risk,” he said. “Non-combustible products should not be taxed at levels that discourage smokers from switching to safer options.”

Adebayo stressed that harm reduction is already recognised under Article 1(d) of the WHO Framework Convention on Tobacco Control (FCTC), noting that countries such as the United Kingdom, Sweden, and Japan have seen significant declines in smoking rates after incorporating THR into their tobacco control strategies.

He also highlighted the need for improved professional training and public confidence, pointing to a 2024 study in the International Journal of Medical Students which found uncertainty among Nigerian medical trainees about applying THR principles. This gap, he said, reinforces the need for science-based education.

The expert recommended the establishment of independent advisory structures and robust post-market surveillance systems to monitor product safety, usage patterns, and long-term health outcomes.

“With the right mix of science, regulation, and public education, Nigeria can meaningfully reduce the health impacts of smoking while empowering adults with safer choices,” he said.

Adebayo added that the country now has a clear opportunity to pursue “a balanced, evidence-based pathway to better health outcomes” by integrating harm reduction into national tobacco control policy.