Graphic Health Warnings on Vapes and Oral Nicotine Pouches, Is There Any Evidence to Support Them?



● The Ministry for Health in April 2024 announced that it was inviting submissions from the public on proposals to apply graphic health warning labels on tobacco products – which according to the draft graphic warnings shared by the Ministry, includes nicotine products like vapes and pouches.

●    Graphic Health warnings currently appear on cigarettes in Kenya, but there is concern by public health and smoking-cessation campaigners that warnings on tobacco-free nicotine products could prevent smokers from switching to safer alternatives.

●    Scientific evidence indicates that vapes and nicotine pouches are lower risk than tobacco products as they do not burn tobacco – which causes the majority of harm from smoking. Independent research shows that vaping is one of the best tools for helping smokers quit.

Public health advocates in Kenya are writing to the Ministry of Health and will present at public hearings highlighting their concerns that the proposed graphic health warnings for nicotine alternatives are misleading and will deter smokers from switching to potentially life-saving products.

What warnings are planned for tobacco-free nicotine products?
Numerous warnings have been proposed for vapes and tobacco-free nicotine pouches. The warnings misleadingly claim that the products are “not a safe alternative to cigarettes” and cause “mouth cancer.” 

Rolls of cigarettes stacked up together.


Other warnings proposed for vapes state “Warning tobacco use kills,” despite vapes containing zero tobacco. These warnings are accompanied by excessively grotesque imagery that doesn’t accurately represent the risks associated with using the products.

What evidence is there that tobacco-free nicotine products are a safer alternative?
It’s widely agreed that it is the thousands of chemicals contained in tobacco smoke that make smoking so dangerous. There is no combustion in Vapes and oral nicotine pouches, meaning that people who switch completely from smoking to vaping or pouches have significantly reduced exposure to toxins associated with cancer, heart disease and stroke.

A recent evidence review published by the Royal College of Physicians, which represents 40,000 physicians worldwide, found that e-cigarettes are significantly less harmful than cigarettes. The systematic review of years of international research found that vapes are “demonstrably less harmful than smoked tobacco to user and bystander alike” as they contain a fraction of the toxins found in tobacco smoke.

A report titled “Review of the risks and toxicants of smokeless tobacco, areca nut and khat products available in Kenya” by researchers at the University of Nairobi found that the risk profile of tobacco-free nicotine products including pouches was found to be significantly lower than other tobacco and oral products.

“Rather than being a source of harm like other tobacco and oral products, tobacco-free smokeless nicotine alternatives have the opportunity to reduce smoking-related disease. It’s important that any future regulatory system recognises that these products are comparatively low risk.” – Dr Michael Kariuki, lead researcher of the report.

Are tobacco-free nicotine products risk-free?

Tobacco-free nicotine products are not completely risk-free, but they are substantially less harmful than smoking. Nicotine has been regarded as an effective tool to help smokers quit for decades and is on the World Health Organisation’s list of essential medicines in the form of nicotine replacement therapies like patches, gums and sprays. No one who doesn’t smoke and no one under the age of 18 especially should ever use nicotine products.

Do these products actually help smokers quit?
The Royal College of Physicians says that e-cigarettes should be promoted as an effective means of helping smokers to quit. Significant research has been conducted into the effectiveness of nicotine alternatives as a cessation tool, and the results are impressive.

The leading international scientific body Cochrane published a major report in January which studied the experiences of 27,235 smokers. It found that vapes are twice as effective as patches, gums, lozenges or other traditional NRTs for helping smokers quit for six months or longer.

“For me personally, vaping was the only thing that worked. I struggled to give up cigarettes for years and now I’m nearly ten years smoke-free thanks to vaping. I’ve never looked back.” – Joseph Magero, Chairman of CASA.

What will happen if the graphic health warnings proposals aren’t amended?
The fear is that the current proposals to apply graphic health warnings on tobacco-free nicotine products will mislead smokers about the risks of nicotine alternatives and deter smokers from switching. If this happens, the opportunity to save smokers’ lives will be lost.

The Royal College of Physicians warns against lumping safer alternatives like patches and gums together with tobacco products in terms of risk communication due to their valuable role as a smoking cessation tool, which is exactly what the Ministry of Health in Kenya is doing in the current proposals.

“Our number one priority should be helping smokers to quit. Not scaring them away from products that reduce their health risks and could potentially save lives” – Joseph Magero, Chairman of CASA.

What are other countries doing?
While some countries like Kenya are trying to apply the same restrictions to tobacco and tobacco-free nicotine alternatives, other countries like Sweden and the UK actively promote alternatives as cessation tools.  

In the UK, vape starter packs are given to smokers in hospitals to help them give up cigarettes and the Royal College of Physicians credits nicotine alternatives with helping 30,000 – 50,000 additional smokers to successfully quit each year in England.

In the past 15 years, the Swedes have cut their smoking rate from 15 to 5.6% by ensuring that safer alternatives to tobacco remain affordable, available and acceptable. In the next few months, Sweden is set to become the first country to become officially ‘smoke-free’ thanks to this approach.

What will the Ministry of Health do next?

The Ministry of Health on 30th April, closed its request for written submissions on the draft Graphic Health Warnings for tobacco products. It is now in the process of conducting public hearings around the country on the draft proposals, with the last one scheduled for 8th May in Machakos. At the conclusion of the public participation exercise, a consolidation of the submissions by the public and key stakeholders will follow within the next two to four months, at which point, there will be recommendations for further refinement and review by the Tobacco Control Board before the graphic warnings are then shared with the Health Cabinet Secretary for publication and subsequent consideration and approval by parliament.

A young person smoking



Leave a Comment

Your email address will not be published. Required fields are marked *



Click one of our contacts below to chat on WhatsApp