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Allafrica had the privilege of speaking with Bahman Safakish, Managing Director of the Pan African Region for Philip Morris International, to discuss tobacco harm reduction strategies in Africa.

In this interview, we explore the company’s stance, innovations, regulations and efforts in promoting safer alternatives and reducing the health risks associated with tobacco consumption.

Your company, Philip Morris International (PMI), one of the largest tobacco companies advocates for harm reduction. What can you tell us about it coming from Big Tobacco?

Since 2008, PMI has devoted a significant amount of resources towards scientific development and substantiation of alternatives to combustible cigarettes. We call these novel products “Smoke Free Products” (“SFP“) because they present less risk of harm to adult smokers who switch to these products versus continued smoking.

According to the World Health Organization estimates of tobacco use prevalence for 2020- 2025, there will be over a billion smokers by 2025 and the goal is to reduce the prevalence of smoking by 30 per cent. The primary cause of smoking-related illnesses is the high number and level of harmful and potentially harmful substances in cigarette smoke, most of which are formed during the combustion process. We’re building PMI’s future on SFP that are a much better alternative and choice compared to cigarette smoking for adult smokers who would otherwise continue to smoke. The best choice any smoker can make is to quit tobacco and nicotine altogether, but we know that most will continue to smoke cigarettes. For those adults providing factual information and access to scientifically substantiated SFP is a sensible approach.

Our advocacy for harm reduction stems from our commitment to the smoke-free future. We believe in providing legal age smokers with scientifically substantiated alternative products that offer a reduced risk profile compared to traditional smoking, therefore we believe its is important to raise awareness and understanding about Tobacco Harm Reduction (“THR“) among African legal age smokers, healthcare professionals and policymakers to enable evidence-based discussion and their informed decision making.

Can you share concrete examples of Tobacco Harm Reduction (“THR”) success in other demographics and why should Africa embrace it?

The smoke-free journey for PMI started in 2014 by the introduction of heated tobacco product in Japan.  In 2000, 50 percent of all men and 33 percent of all adults in Japan smoked cigarettes. Ten years later, Japan’s decline in cigarette sales was still lagging far behind comparable countries, reveals PMI’s SmokeFreeJapan Factsheet. But in 2015, something changed. Sales of cigarettes began declining five times faster than in preceding years. Several independent studies, suggest that the introduction of heated tobacco product was the likely reason of the accelerated pace of cigarette sales in Japan.

Another good example is Sweden where the availability and use of smoke-free alternatives supports efforts putting an end to smoking. With the lowest smoking rates in the EU at 5.8%, this is likely thanks to snus oral tobacco pouches. A new report by Global Health Advocacy Group Smoke Free Sweden has revealed key data points. Compared to the rest of the European Union, Sweden boasts 44% fewer tobacco-related deaths, a 41% lower cancer rate, and 38% fewer deaths attributable to any cancer, states the report. Swedes have switched their preference to alternative, Smoke Free Products (SFP) and they have thereby spawned a smoke-free generation.

The Swedish experience is a showcase of how having smoke-free products that are accessible, affordable, and acceptable alternatives for adults who don’t quit altogether, can deliver monumental gains to public health.

I believe the African legal age smokers should have the choice and access to scientifically substantiated novel SFP and shouldn’t be deprived or left behind for several reasons.

Tobacco-related diseases are a significant public health burden in Africa, leading to millions of premature deaths each year. Cigarette smoking is spreading even more in middle- and low-income countries. Without embracing Tobacco Harm Reduction which can complement existing measures intended to encourage cessation and prevent initiation, smoking will likely continue to be one of the biggest public health burned over the next decade.

According to estimates from the World Health Organization’s 2023 Key Facts, around 80% of the world’s 1.3 billion tobacco users live in low- and middle-income countries.

Tobacco Harm Reduction is a global trend supported by several public health experts, policymakers, and advocacy organizations like the local THR groups. By actively participating in harm reduction initiatives, Africa should align with international best practices and benefit from shared knowledge, resources, and experiences.

What are the regulatory challenges your company faces in promoting Tobacco Harm Reduction (“THR”) and Smoke Free Products (“SFP”) in African markets, and how do you address them?

The main regulatory challenge is the lack of understanding of the need for differentiation in regulating Smoke Free Products (“SFP”) by the regulators, which can mean imposing equivalent fiscal and regulatory measures that are applied to combustible tobacco products. Pursuing a harsh stance towards these products will limit options for mitigating health risks and will not deliver better, long-term public health benefits.

There is a crucial need for pragmatic recognition of the potential merits of these products as a tool for reducing harm and meeting public health benefits and the need for a differentiated treatment of Smoke Free Productsfrom combustible tobacco products.  While SFPsare not risk free and contain nicotine which is addictive, providing access to, and information about scientifically substantiated Smoke Free Products to adult smokers who would otherwise continue to smoke allows them to make an informed decision to move away from the most harmful form of nicotine consumption, combustible tobacco products.  Regulators have to understand the science on THR and on the category SFPand that SFPsare not the same product as combustible tobacco because they don’t present the same health risks.

Regulatory challenges in promoting Tobacco Harm Reduction in African markets often involve navigating complex and evolving legislation, as well as addressing concerns about youth initiation. To address these challenges, we engage in transparent communication with regulatory authorities, provide evidence-based research to support our claims, and advocate for balanced regulations that prioritize public health. While recognizing the potential benefits of Smoke Free Products, we favor tailored restrictions on usage to provide adult smokers with the choice of switching to lower health-risk alternatives to cigarettes, whilst restricting access to unintended groups, including youth and never users.

To increase awareness and understanding of the science on Tobacco Harm Reduction and of the Smoke Free Products category in Africa, we engage in fact-based communication with healthcare professionals, and regulatory bodies as well as public health agencies.

We recognize the diversity of cultural attitudes towards tobacco use in Africa. Our approach involves culturally sensitive messaging and community engagement efforts to promote harm reduction while respecting local customs and traditions.

What specific steps is your company taking to engage with African governments and public health organizations to advance Tobacco Harm Reduction (“THR”) efforts?

Our company is actively engaging with African governments and public health organizations to advance Tobacco Harm Reduction efforts. We actively participate in policy discussions, provide scientific evidence, and offer support for regulatory frameworks that prioritize harm reduction. By fostering open dialogue and collaboration, we aim to build trust and credibility within the public health community and contribute to meaningful progress for the benefit of public health.

It is critical that THR and the potential of SFPs to move adult smokers away from combustible tobacco products is properly understood by regulators, the scientific community and society at large. Transparent, fact and evidence-based debate around THR is inevitable and timely for the benefit of public health.

Engagement with African governments and public health organizations is crucial for the success of our harm reduction initiatives. We recognize the unique healthcare challenges facing African countries and strive to integrate THR into broader public health agendas. By aligning our initiatives with local priorities, we can better address the needs of these communities.