A number of Low and Middle-Income Countries (LMICs) experts and researchers were invited to share their perspective on Tobacco Harm reduction (THR) in their respective country during a two-day conference organized by the Global Forum on Nicotine in Warsaw, Poland from June 16th to 18th.
Most of LMICs don't have access to new nicotine products as the legislation simply ban them. But for those who already have access to them – such as South Africa - affordability seems to remain a structural challenge. During the panel on "tobacco industry transformation", a South African participant in the audience shared her concern:
"The poor are sort of left behind. For cigarette consumers in developing countries such as mine in South Africa the products themselves are expensive and we have a lot of consumers who are dependent on government grants and some are not willing to spend it on a device… maybe the refills might be cheaper but the device itself is expensive and I'd rather buy food than a device."
Flora Okereke, Head of Global Regulatory Insights and Foresights at British American Tobacco (BAT), and Nigeria native tried to be reassuring:
"I am from Africa, and I know the region very well, and the income level. The journey to our destination will carry on. In British American Tobacco, we have different categories of products some are expensive, and some are less. And I am sure that with time, just like telephones, the price will keep coming down. In developing countries people can't afford the higher devices but it is possible. It is just a matter of time."
It seems to be the same story for Yusuff Adebisi Adebayo, a young Nigerian pharmacist and soon to be researcher on THR (GFN fellow). In his opinion, the cost of these alternatives could be a challenge. However, he said, the results on health level will finally speak for themselves for a majority of smokers and economy of scale could follow with cheaper products:
"Cost would be a problem as these products may even eventually be heavily taxed. A lot of people who have been introduced to these products have changed to the alternatives like e-cigarettes and vaping as mentioned at GFN. Some have even stopped smoking. We just have to weigh the benefits of these products with the inability to stop smoking at all. There is a huge difference in side effects and that is what will bring more advocacy for probably more production, less scarcity and therefore less cost in the coming years."
Another world leading international tobacco company, Philip Morris International (PMI), plan to expand in Africa with its new alternatives. They claim to be aware of the specificities of LMICs but declare that in the end, no one will be left behind:
" Most of the messaging we use in the rest of the world and the pricing that we use in the rest of the world, and the way we commercialize our smoke free alternatives do not necessarily apply to Low and Middle-Income consumers. This is why we have a full program for us to be able to address more and more consumers with bespoke approach in terms of the products we are developing, bespoke approach in terms of the messaging that we are going out with, and bespoke approach in terms of the affordability of our smoke-free alternatives. So, the intentionality of putting those consumers at the center of our design and consumer proposition is the most important step we take for us to be able to make a significant step forward with regards to LMICs. This is fundamental.", said Stefano Volpetti, President of the Smoke-Free products category & CCO at PMI during an event on innovation (Technovation) organized by the company at their Research &Development headquarters, in Switzerland, on June 14th, 2022.
The smoking incidence has risen by 50% in Africa over the past 35 years and the number of smokers is expected to increase from 52 million people in 2000, to 84 million people in 2025 according to the World Health Organization.
