Failure rate for smokers trying to quit is very high—Malawi’s internal medicine specialist Dr. Kayange

Maravi Express

The failure rate for smokers trying to quit smoking is very high and that some smokers fail to quit even faced with a life threatening disease, says Malawi’s internal medicine specialist Dr. Noel Kayange.

Kayange, who runs a private medical practice in Blantyre, told Face of Malawi that e-cigarettes and nicotine replacement therapy products are definitely better options and less risk.

E-cigarettes, a new innovation by tobacco products manufacturers that heat but does not burn, are only 5% harmful compared to conventional combustible cigarettes because the tar in burning cigarettes is very dangerous.

Kayange added that the risk for smokers is even higher in developing countries like Malawi because some smokers use non-filtered cigarettes which are an even bigger health risk.

He, however, noted that whilst he recommends Tobacco Harm Reduction (THR) products to his patients, these are very expensive and not always available making them a non-viable option at times.

The interview came about following a virtual conference that UK-based public health agency Knowledge Action Change launched under the theme ‘Burning Issues: The Global State of Tobacco Harm Reduction’, which was the latest in a landmark report series.

Face of Malawi reports that tobacco harm reduction (THR) supports people to quit smoking by using safer nicotine products including vaping devices (e-cigarettes) and pasteurised oral snus, improving health and reducing deaths by enabling people to use nicotine without the smoke that causes disease.

For the average Malawi smoker, alternative smoking products remain unheard of. Whilst Malawi has witnessed a number of awareness anti-smoking campaigns, THR products have not been highlighted as a possible solution.

One of Malawian speakers at the event, Chimwemwe Ngoma, a THR advocate who runs THR Malawi — an information disseminate project on nicotine science — presented to the audience that there is a lack of knowledge and limited access to THR products among the local smoking population.

He added that in most low to middle income countries (LMICs), THR products are very expensive compared to easily accessible combustible cigarettes.

President of the Medical Society of Malawi, Victor Mithi told Face of Malawi in an interview that he was of the view that smokers should be encouraged to quit as opposed to seeking less harmful options.

“We do not have enough local scientific data on the impacts of tobacco smoking but we would be more inclined to encourage smokers to quit smoking completely instead of opting for other tobacco products,” Mithi is quoted as saying.

The Burning Issues report reveals that there’s only an estimated 9 safer nicotine products and that smoking health crisis is ongoing and deadly.

About 1.1 billion people smoke worldwide, a figure that has remained unchanged for two decades despite billions spent by governments and the World Health Organization (WHO) on tobacco control.

Although the use of SNP seems to be slightly rising, especially after the US Food and Drug Administration’s approval of Phillip Morris International’s IQOS — a modified risk tobacco product — the reports notes that there is a still worrying poor THR support and awareness in LMICs.

According to the report, 80% of the world’s smokers live in LMICs, and eight million people die due to smoking-related disease every year.

The WHO estimates that one billion people will die of smoking-related disease by 2100.

David Nutt, one of the main speakers and founder of Drug Science — a leading independent scientific body on drugs in the UK — told the conference  that there is an urgent need to find new approaches is clear, especially in LMIC, where tobacco control measures are often poorly or partially implemented.

He said smoking rates are high or plateauing, population growth is increasing the number of smokers, and health systems are least able to treat smoking-related disease effectively or offer smokers support to quit.

According to the Burning Issues report, since SNP have become available, accessible and affordable in countries such as Japan, the UK and Iceland, existing declines in smoking rates have accelerated despite the emergence of products that are demonstrably safer than combustible cigarettes.

Malawian smoker, Grace Kamphale says she used e-cigarettes in 2015 and would spend an estimated K40,000 ($53) a month on the gadget and supplies.

In 2020, she spent nearly K65,000 ($86) on the same and she bemoans that THR products are generally expensive and difficult to manage compared to regular cigarettes.

The average Malawian earns $60 a month indicating that one of the biggest bottlenecks to access to THR products for Malawians would be the high cost.