Nigeria’s pathway to saving thousands through tobacco harm reduction 

Tobacco Harm Reduction (THR) offers a forward-thinking approach that complements cessation and prevention by providing adult smokers who would otherwise continue smoking with potentially less harmful alternatives. In Nigeria, where smoking prevalence has declined but pockets of use persist, embracing innovative solutions like THR could significantly reduce health risks and ease pressure on our healthcare system.

Traditional tobacco control strategies, including taxation, advertising restrictions, and smoking bans, have had limited success primarily because they do not address the reality that many smokers find it incredibly difficult to quit. This is where Tobacco Harm Reduction (THR) comes in; a scientifically backed approach that offers adult smokers’ access to Reduced-Risk alternatives like nicotine pouches, heated tobacco products, and e-cigarettes, which reduce harmful combustion-related toxins.

Despite the growing global evidence supporting THR in Nigeria, there is a knowledge gap in what THR is, which has stifled its acceptance and consequently made it difficult to integrate it into its public health policies.

The World Health Organization’s MPOWER framework, which guides global tobacco control efforts, does not include harm reduction as a key strategy even though harm reduction strategies are included as a strategic option in the WHO Framework Convention on Tobacco Control. This omission limits countries like Nigeria’s ability to implement a holistic approach to reducing tobacco-related harm as they are not aware or are misinformed on these other alternatives.

The Nigerian government must recognise that a risk-proportionate regulatory framework—one that differentiates between the harms of combustible cigarettes and the lower risks associated with non-combustible nicotine alternatives—is essential. Implementing policies that make Reduced-Risk products more accessible while continuing to regulate combustible cigarettes will help millions of Nigerians transition to safer alternatives.

Ideally, Nigeria should not rely solely on foreign research to shape its THR policies. Homegrown scientific studies that assess the impact of Reduced-Risk Products in the Nigerian context are needed. Local research institutions, universities, and public health bodies should begin to address the research gaps around smoking behaviors, harm reduction efficacy, and policy effectiveness.

Public awareness campaigns are also crucial. Many Nigerians remain unaware that alternatives like e-cigarettes and nicotine pouches exist or that they have reduced risk when compared with   traditional smoking. Misinformation and fear-mongering have led to skepticism about Reduced-Risk Products, despite the scientific evidence supporting their benefits when compared with traditional cigarettes. A well-structured education campaign, backed by health professionals, community influencers and even the government, can help dispel myths and encourage informed decision-making. This approach has been key to the success of harm reduction strategies in countries such as the United Kingdom, Sweden and New Zealand.

Nigeria has a unique opportunity to lead the charge in tobacco harm reduction across Africa, by embracing a science-driven, evidence-based approach, achieving this requires a collective effort from the government, health professionals, researchers, and civil society.

The time to act is now. Nigeria cannot afford to delay; The Tobacco Harm Reduction approach offers a vital lifeline for millions of smokers who want to quit or switch to Reduced-Risk alternative products. With the right policies, education, and leadership, the country can mitigate tobacco-related deaths and build a healthier future for generations to come.