Joseph Magero
As Africa celebrates World Oral Health Day, the emphasis usually lies on brushing, dental visits, and preventive care. But one of the most persistent threats to oral health across the continent, cigarette smoking, calls for a more nuanced, evidence-based response.
For years, public messaging has treated all nicotine use as equally harmful. However, emerging research from institutions such as the Center of Excellence for the Acceleration of Harm Reduction, CoEHAR highlights an important distinction: it is not nicotine itself, but the toxic chemicals produced by burning tobacco that drive most smoking-related oral disease, including oral cancer.
This is where oral nicotine products, such as nicotine pouches, provide a compelling alternative. Unlike cigarettes, they don’t involve combustion. By delivering nicotine without burning tobacco, they greatly reduce exposure to harmful toxicants. Research from CoEHAR shows that these products contain much lower levels of carcinogens compared to combustible cigarettes, although long-term data is still developing and ongoing studies are required.
There is currently no clear evidence establishing that nicotine pouches cause oral cancer, and nicotine itself is not classified as a carcinogen, though it remains addictive. Some users may experience mild oral irritation or dry mouth, but these effects are generally less severe than the damage caused by smoking.
In the African context, oral nicotine products also offer practical advantages. There is cultural familiarity with oral tobacco in many communities, making adoption more natural. They require no electricity or devices, increasing accessibility in rural and low-resource settings. They are also often more affordable than vaping products, which is a key consideration where cost strongly influences consumer behavior.
On this World Oral Health Day, improving oral health must go beyond prevention messages. It must include realistic harm reduction strategies that reflect how people live and make choices today. While quitting nicotine entirely remains the ideal, providing safer alternatives for those who continue to smoke can play an important role in reducing disease and improving public health outcomes across Africa.
