A leading Nigerian health expert has called for a major shift in the country's approach to tobacco control, urging the adoption of a science-driven strategy to reduce the health risks for adults who continue to smoke.
A Pragmatic Public Health Tool
In a recent commentary, Dr. Yusuff Adebayo, a pharmacist, epidemiologist, and health systems researcher, made a compelling case for Nigeria to integrate Tobacco Harm Reduction (THR) into its national public health framework. He described THR as a pragmatic and evidence-based tool designed to work alongside traditional anti-smoking measures, not replace them.
Dr. Adebayo pointed to the reality revealed by decades of global tobacco control: a segment of adult smokers will continue to seek nicotine. With about 3.7 per cent of Nigerian adults still smoking according to the 2023 WHO Global Adult Tobacco Survey, he argued that policymakers must offer safer alternatives to those unable or unwilling to quit entirely.
The Science Behind Safer Alternatives
The expert backed his argument with international scientific evidence. He referenced a 2022 review by Public Health England which concluded that vaping is at least 95 percent less harmful than smoking cigarettes, primarily because it eliminates the smoke and tar that cause most tobacco-related illnesses.
He also cited decisions by the U.S. Food and Drug Administration (FDA) to authorize certain heated tobacco and oral nicotine products as Modified Risk Tobacco Products. This authorization is based on evidence showing these products expose users to far fewer toxic chemicals than conventional cigarettes.
Building a Risk-Proportionate Framework for Nigeria
For Nigeria to benefit, Dr. Adebayo stressed the need for a clear, risk-proportionate regulatory framework. This system should encourage smokers to switch to scientifically substantiated, lower-risk products while ensuring strict standards for safety, quality, 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 stated. He emphasized that non-combustible products should not be taxed at prohibitive levels that would deter smokers from making the switch to safer options.
This approach finds support in international guidelines, as harm reduction is recognized under Article 1(d) of the WHO Framework Convention on Tobacco Control. Dr. Adebayo pointed to countries like the United Kingdom, Sweden, and Japan, where similar risk-reduction strategies have contributed to significant declines in national smoking rates.
The Path Forward: Trust, Education, and Surveillance
Successful implementation requires building public trust and fostering collaboration. Dr. Adebayo called on policymakers, civil society, manufacturers, and the medical community to base all decisions on robust science and balanced information.
He highlighted a gap in knowledge, referencing a 2024 study in the International Journal of Medical Students that found uncertainty among Nigerian medical trainees about applying THR principles. This underscores the critical need for proper education and training for healthcare professionals.
His final recommendations included establishing independent advisory structures and implementing rigorous post-market surveillance to monitor product use 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," Dr. Adebayo concluded. He sees the current moment as a clear opportunity for Nigeria to adopt a balanced, evidence-based pathway to better national health.
