Challenges and opportunities for snus as a tobacco harm reduction product in Malawi
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Abstract
Background. Tobacco use remains a global public health challenge, including in Malawi. Evidence from many countries indicates that availability of safer nicotine products, including snus, helps drive down smoking rates. Snus is an important potential harm reduction tool in resource-poor settings where smoking cessation services are few and where other safer products, including e-cigarettes and heated tobacco products, are expensive. Malawi is a tobacco-growing country with the ability to produce snus, but the potential of snus as a harm reduction tool in Malawi remains insufficiently explored.
Objective. To explore the feasibility and acceptability of snus as a harm reduction tool among smokers seeking cessation services at Daeyang Luke Mission Hospital in Lilongwe, Malawi.
Methods. The 4-month study employed a prospective observational design with baseline and follow-up data. After enrolment in the study, participants were provided with snus. Data collection involved administering semi-structured questionnaires and monthly follow- ups to monitor snus usage and experience. The study faced challenges such as limited sample size and diversity needed to draw broader conclusions. Another challenge was the uniform provision of snus without assessing participants’ nicotine dependency levels or individual needs.
Results. The age range of the 34 study participants was 19 - 64 ears. Only 14 participants had prior knowledge of safer nicotine products. Of the 14, only one participant knew about snus. Of the 34 participants, 28 reported a positive experience with snus, such as improved oral hygiene and absence of second-hand smoke, indicating acceptability of the product.
Conclusion. The study highlights the potential of snus as a feasible harm reduction tool for smokers seeking to quit cigarette smoking, suggesting that it could be incorporated into smoking cessation interventions and tobacco control strategies.
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