Africa: Global Forum on Nicotine - Reducing Harm and Saving a Billion Lives in this Century

23 June 2016

The 3rd Global Forum on Nicotine (GFN) was held June 17 & 18 17 in Warsaw. This annual international conference brings together stakeholders in smoking and less harmful ways to consume nicotine.

350 delegates from 55 countries and 40 speakers attended the Forum. They range from public health experts, to electronic cigarette activists, e-cigarettes and e-liquids manufacturers as well as representatives of the tobacco industry.

According to Prof. Gerry Stimson, a British academic and GFN Coordinator, "most smokers say they want to quit smoking but very few actually succeed because of the difficulties involved. For the vast majority who can't give up their habit, alternative - less harmful - nicotine delivery system (ENDS) that does not involve burning tobacco has to be made available".

Yet, the debate over the issue of safer alternatives to smoking like electronic cigarettes remains very divisive. The vast majority of the delegates present at the Forum believe it is the best way forward to save lives. They also believed like Prof. Stimson that opponents to this view base their arguments on scaremongering, bad science and legislation. He is also onvinced that the issue is not openly discussed. Hence, the GFN theme of this year "Evidence, Accountability and Transparency".

Greek cardiologist Konstantinos Farsalinos of the Onassis Cardiology Center stated clearly that nicotine consumption through electronic cigarettes is undoubtedly less dangerous than traditional cigarettes smoking because there is no combustion. This was confirmed in 2015 by the Public Health England and the Royal College of Medicine in the UK. He gave an estimate of the risk reduction to health: 95% because there are no toxic substances due to the combustion of tobacco and the presence of any other harmful products in the liquid used in electronic cigarettes is very minimal. He sees it as a clear evidence that tobacco alone is not the issue but tobacco combustion is. He concludes that the focus must be put on smoking, not on tobacco and nicotine indiscriminately.

Harm reduction in Africa and the Middle East, an overlooked subject that has not yet been fully measured

Even though the number of tobacco users is declining in developed countries, it is rising in Africa and the Middle East, therefore the number of smokers is still increasing globally.

Public health specialist from Senegal, Professor Ibra Wane stated at the GFN that "In Senegal, 500,000 men and women use tobacco products, (3.8 % of the total population of 13 million). 11% of Senegalese men and 1.2% of women smoke. The most commonly used type of tobacco is manufactured cigarettes. In comparison to smoking tobacco, smokeless tobacco and other alternatives are used by very few Senegalese (0.7%)".

Egyptian Doctor Nasser Loza, Director of The Behman Hospital in Cairo, explained that « e-cigarettes are available in a very limited context at the moment, we are a low middle income country and we've had our share of political and economic upheavals in recent years so at the moment they are not available. We hope that will change soon. We are hoping to be able to take the message back and say we need to do something about it".

His counterpart of the United Arab Emirates, Cardiothoracic Surgeon Doctor Obaid Aljassim, Vice President of the Emirates Cardiac Society, didn't draw a different picture but for a different reason. In the UAE, alternatives like e-cigarettes are simply prohibited: « e-cigarettes are banned in the UAE for the time being, that's why I'm attending a scientific conference to know more, to have a scientific understanding of new nicotine delivering systems and how they work including other lower risk alternatives. People who decide to continue smoking can now be offered less harmful alternatives to smoking. »

Given the rising number of smokers in Africa and the very limited number of safe alternatives, African delegates to the Forum believed that it is time to raise the debate on the continent to make sure stakeholders have the emerging scientific information about smokeless tobacco.

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