By Dr Michael Kariuki, Harm Reduction Society of Kenya

As Kenya considers amendments to its tobacco-control framework, one issue deserves greater attention in the public debate: not all nicotine products carry the same health risks.

The proposed legislation places a range of nicotine products under the broad category of “tobacco products”, including products that may contain no tobacco. From a scientific perspective, however, cigarettes, electronic cigarettes and nicotine pouches differ significantly in how nicotine is delivered and, more importantly, in the harmful substances to which users are exposed.

The greatest health burden associated with conventional cigarettes comes from combustion. Burning tobacco produces thousands of chemicals, including many toxic and carcinogenic substances. Smoke-free nicotine products do not involve the same combustion process.

That does not make vaping or nicotine pouches harmless. Nicotine is addictive, and the long-term health effects of some newer products are still being studied. But acknowledging that risk should not obscure the important distinction between products that are harmful and products that are substantially more harmful.

The UK government’s evidence review concluded that, in the short and medium term, vaping poses only a small fraction of the risks associated with smoking, while stressing that vaping is not risk-free and that evidence on longer-term effects remains limited.

There is also substantial evidence concerning vaping as a smoking-cessation tool. The latest Cochrane review found high-certainty evidence that nicotine electronic cigarettes increase quit rates compared with conventional nicotine replacement therapy, including products such as patches and gum. At the same time, the review notes that longer and larger studies are still needed to assess longer-term safety.

Nicotine pouches are a newer category and therefore have a less mature evidence base. Nevertheless, developments in the United States illustrate the growing regulatory recognition of differences in risk between specific products. In June 2026, the US Food and Drug Administration authorised 20 ZYN nicotine pouch products to be marketed with a specific modified-risk claim after scientific review. The FDA concluded that those particular products exposed users to substantially lower amounts of harmful constituents than cigarettes.

This is not an endorsement of every nicotine pouch on the market. The FDA’s decision applies only to the specific products it reviewed and authorised.

The debate over flavours also requires care. There are legitimate concerns about products that may appeal to children and young people, particularly given the role of flavours in making nicotine products more attractive. Research at Yale and elsewhere continues to examine how flavours influence nicotine use, cessation and youth appeal.

That evidence points towards regulation that is targeted rather than indiscriminate. Youth access, marketing, packaging, product standards and enforcement all deserve serious attention. But policymakers should also consider the possibility that excessively broad restrictions on products used by adult smokers could affect their willingness or ability to move away from cigarettes.

The principle behind harm reduction is straightforward. Complete abstinence from tobacco and nicotine remains the lowest-risk option. For adults who continue to smoke, however, moving completely away from combustible cigarettes to products that expose them to fewer harmful chemicals may reduce health risks.

This distinction should inform Kenya’s policy debate.

The objective of tobacco regulation should be to reduce disease, protect young people and discourage initiation while ensuring that adult smokers have accurate information about the relative risks of different products.

A cigarette, a vape and a nicotine pouch should not automatically be treated as interchangeable simply because they involve nicotine.

The science is not static, and policymakers should remain open to new evidence. But the evidence already establishes several important points: combustion matters, relative risk matters and the health consequences of smoking cannot simply be equated with those of every newer nicotine product.

Kenya’s tobacco legislation should therefore reflect these distinctions. Good regulation should protect public health without losing sight of the differences between products, the quality of available evidence and the potential consequences for adults trying to move away from cigarettes.

The test is not whether every nicotine product can be declared safe. None can.

The test is whether legislation accurately reflects the science and uses that evidence to reduce the greatest source of tobacco-related harm.