Transforming the Tobacco Industry: Challenges and Opportunities in LMICs

"I do not think there is any doubt or debate that reduced risk products should be available and accessible to consumers of risky forms of tobacco products in LMICs." - Joseph Magero

In the bustling halls of the recently concluded Global Forum on Nicotine, experts from various disciplines came together to accelerate the reach and impact of tobacco harm reduction. The forum aimed to spark actionable strategies that could be carried forward beyond the conference, bringing a ray of hope to millions of smokers.

The forum uncovered business facilitators, decision matrices, regulatory frameworks, and success stories that could be leveraged to drive the widespread transformation of the tobacco industry.

In one of the sessions focused on actionable solutions for LMICs, Dr. Emily Adams, a renowned public health expert, said, "Reduced-risk products are the way forward for consumers of risky tobacco forms in LMICs". It is a striking reality that while reduced-risk options like electronic cigarettes and heated tobacco products are readily available in Europe and Northern America, their presence in LMICs remains sparse.

Astonishingly, nearly 80% of consumers of combustible forms of tobacco reside in these countries, necessitating a shift in focus. Smokeless tobacco, prevalent in regions like South Asia, Africa, and Southeast Asia, poses less risk. The forum's panel was comprised of experts from the consumer world, the tobacco control sector, and the corporate domain who explored potential insights and perspectives from all angles.

Joseph Mugero, a stalwart in tobacco control from Kenya, brought to light the challenges faced by LMICs. ‘‘With a staggering 77 million smokers and a quarter-million smoking-related deaths in Africa alone, the need for affordable cessation services and products was paramount.’’ Joseph pointed out that recommended nicotine gum and patches, though effective, were often financially out of reach for most smokers in LMICs. He fervently expressed his desire to understand what the industry was doing to address this issue and provide accessible alternatives for smokers willing to switch.

Atul Agarwal, an expert in supply chain management, provided a deeper understanding of the LMIC market. He highlighted the contrasting scenarios in developed and developing countries. ‘‘While reduced-risk products have found a comfortable home in developed countries, their rollout in LMICs faced hurdles due to regulatory uncertainties and varying enforcement capacities.’’ Atul raised thought-provoking questions about the catalysts and facilitators required to motivate tobacco companies, governments, and consumers ign LMICs to adopt and make reduced-risk products widely available. He also shed light on the decision matrices employed by companies when launching new products, trying to interpret their apparent reluctance to do so where it is legal.

Flora Okereke, a senior executive at British American Tobacco (BAT), described the transformation journey of the tobacco industry. ‘‘BAT's dedication to developing safer products and improving the health impact of its business has led to significant investments in science, technology, and innovation,’’ Flora said that BAT had already launched a variety of safer products in 60 markets, including several LMICs. However, she was quick to acknowledge the need for broader availability and accessibility of these products to achieve true health equity.

The panel discussion seemed to resonate with all attendees and ignite a sense of urgency to bridge the gap between the availability of safe nicotine products in developed countries and their limited access in LMICs. 

The journey ahead may be challenging, but with collaboration, innovation, and a steadfast commitment to public health goals, the tobacco industry's transformation in LMICs could be critical in ensuring reduced-risk products are readily available, offering hope to smokers and heralding a new era in public health.