The Vision for Accelerated Sustainable Development Ghana, a public health-focused civil society group, has noted with concern a publication dated 24th May 2025, on Joy News online, authored by Peter Bismark, under the caption “Ghana’s roadmap to a safer future through Tobacco Harm Reduction: Reflections on the Lives Saved Report”.
In the publication, the writer sought to push for Ghana to accept Tobacco Harm Reduction strategy against the World Health Organization Framework Convention on Tobacco Control (WHO FCTC) measures to reduce or prevent harm caused by tobacco and nicotine use. The article suggests that public awareness of Tobacco Harm Reduction (THR) and so-called Reduced-Risk Products is limited, contributing to public resistance and hindering integration of THR into national health frameworks.
VAST Ghana and other key stakeholders firmly reject the persistent call by tobacco industry allied groups masquerading as independent think tanks and policy innovators promoting tobacco use, particularly among children, young people and youth, through its so-called Tobacco Harm Reduction (THR) strategies. These strategies have recently fueled the rise of e-cigarettes and vaping products, which contain nicotine and other harmful chemicals, and have contributed to the influx of illicit tobacco products on the market due to misleading narratives around their safety. This rejoinder seeks to expose the flawed assumptions, manipulative framing, and significant public health risks inherent in the Institute of Liberty and Policy Innovation (ILAPI), other allied front groups and the tobacco industry’s push for THR.
First, let us confront the central claim that nicotine pouches, e-cigarettes, and heated tobacco products (HTPs) are “reduced-risk” alternatives, and therefore must be embraced as a public health imperative. This assertion is not only misleading, but also dangerous. If these products are truly therapeutic or clinically safer alternatives to conventional tobacco products, they must be subjected to rigorous clinical trials, classified as pharmaceutical interventions, and dispensed strictly through medical prescriptions at health facilities. Instead, they are aggressively marketed in convenience stores, gas stations, and, most tellingly, online platforms frequented by adolescents. This strategy directly contradicts Ghana’s obligations under the FCTC Article 13 and the Ghana Public Health Act, which calls for a comprehensive ban on all forms of tobacco advertising, promotion, and sponsorship.
Public health interventions must be evidence-based and population-sensitive. Unlike vaccines or antiretrovirals, which undergo years of clinical trials, so-called harm reduction tobacco products are introduced into markets without adequate long-term studies on their cumulative health effects. The reality is clear: these products are not medicines. They are the industry’s trojan horse — products deceptively framed as alternatives while intentionally engineered to sustain addiction and market control. They are products designed, packaged, and promoted to secure a new generation of nicotine users in the face of global tobacco control progress.
The World Health Organization (WHO) has repeatedly warned against the adoption of e-cigarettes and similar products as public health strategies. In its 2023 Call to Action on Electronic Cigarettes, the WHO emphasized that these products are harmful and that their unregulated use undermines decades of progress in tobacco control. The WHO explicitly discourages the use of e-cigarettes as a cessation tool and recommends caution, especially in countries where regulatory infrastructure is weak. In Ghana, the Food and Drugs Authority (FDA) enforces a complete ban on the sale, advertisement, and recreational use of e-cigarettes, classifying them as illegal, while traditional cigarettes remain legal but are subject to stringent regulations under the Public Health Act, 2012, to protect public health.
More importantly, if Ghana were to fully implement the existing provisions of the WHO FCTC, including higher excise taxes, graphic health warnings, complete bans on tobacco advertising, and restrictions on product placement and availability, we would not need to entertain a harm reduction narrative crafted to keep the industry viable. In this context, harm reduction is not about public health; it is a deliberate strategy by the tobacco industry to shift from combustible cigarettes to nicotine-based products like e-cigarettes, sustaining addiction and ensuring ongoing profits by replacing one market with another.
Global health authorities, including the WHO and the U.S. Centre for Disease Control, have raised concerns that these novel nicotine products are increasingly used in dual use — that is, alongside conventional cigarettes — negating any supposed health benefit. Contrary to claims of saving lives, the industry’s THR products are actively creating new forms of addiction. Observation and developing evidence from Ghana and other countries show that most users of e-cigarettes and HTPs are not former smokers seeking cessation; they are young people and youth, and non-smokers attracted by sleek designs, candy flavors, and misleading marketing. In Ghana, there is already a noticeable rise in e-cigarette use among young people. This is not harm-reduction; it is harm redirection toward young people and youth.
If the tobacco industry and its allies genuinely cared about saving lives, they would champion taxation increases, plain packaging, and cessation programs-not lobby for the deregulation of addictive products.
The attempt to draw inspiration from Sweden or the United Kingdom is not only contextually misplaced but ethically problematic. Sweden’s so-called “success” with snus and e-cigarettes occurred in a vastly different regulatory environment, supported by robust surveillance systems, comprehensive cessation support, and a well-informed public none of which exist in Ghana. Critically, Ghana lacks dedicated cessation centers or addiction help centers to address nicotine dependence, leaving addicted young people and youth, at risk. Promoting such models without acknowledging disparities in health literacy, enforcement capacity, and the absence of addiction support is utterly dangerous. Ghana must not become a testing ground for failed strategies imported from different socio-economic and healthcare contexts.
Additionally, the portrayal of nicotine as harmless, as implied by the phrase “People smoke for the nicotine but die from the tar,” misrepresents scientific evidence. While it is true that combustion is a key driver of tobacco-related mortality and morbidity, addiction in any form is harmful, regardless of the product or method of delivery. Strong scientific evidence proves that nicotine itself is far from harmless. It is addictive, affects cardiovascular health, impairs brain development in adolescents, and contributes to anxiety, depression, and other mental health issues. Additionally, prenatal exposure to nicotine has been linked to developmental complications and increased risk of sudden infant death syndrome (SIDS), further debunking the myth of “harmless nicotine.”
The call for a “risk-proportionate regulatory framework” is a thinly disguised attempt to weaken Ghana’s tobacco control laws. By advocating for looser regulations on non-combustible nicotine products, the tobacco industry seeks to flood the market with addictive alternatives while maintaining its grip on public health. This approach contradicts the FCTC’s core principle of prioritizing public health over industry interests. Ghana must reject these tactics and strengthen its commitment to FCTC provisions, ensuring that no loopholes are created for the industry to exploit. We urge Parliament and regulatory authorities to reject any amendments or policy suggestions that seek to normalize nicotine consumption outside of strict medical contexts.
We commend the Ministry of Health, through the Food Drugs Authority, as well as the unwavering role of civil society organizations, particularly VAST-Ghana, for standing firm in the face of aggressive industry lobbying to legalize products that threaten to worsen Ghana’s public health burden.
The tobacco industry’s survival depends on undermining the very measures that have proven effective in reducing smoking. Its latest tactic, framed as ‘harm reduction,’ is a deliberate attempt to derail collective progress in advancing tobacco control.
Let us not be deceived. The future of Ghana’s health cannot be traded for the illusion of innovation. No to the normalization of addiction.
Issued by:
Labram M. Musah
Executive Director, Vision for Accelerated Sustainable Development, Ghana (VAST Ghana)
National Coordinator, Ghana NCD Alliance
Contact: 0243211854
Email: labrammusah@gmail.com
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Rhoda Mingle
Communication Manager
Contact: 0241136371
