How British American Tobacco lobbied Kenya to water down nicotine pouch warnings | Global health

How British American Tobacco lobbied Kenya to water down nicotine pouch warnings | Global health

The Kenyan government weakened health warnings on nicotine pouches after British American Tobacco said it would pull investment from a new factory in the country’s capital, an investigation has revealed.Letters between British American Tobacco (BAT) and the Ministry of Health show the government yielded to the tobacco giant’s demand to sell Velo – one of the biggest-selling nicotine pouch brands globally – with significantly smaller health warnings and without mentioning potentially cancer-causing toxicants present in the products.The letters are among documents shared with the Guardian and Africa Uncensored, and obtained by the investigative news outlet the Examination, which reveal the industry’s influence over policy in the east African country.Existing tobacco regulations in Kenya stipulate that such labels must cover a third of the package and include information about the health hazards of the product. BAT lobbied to reduce the size of the warning, the letters show. The Ministry of Health agreed that Velo could be sold with a small warning saying: “This product contains nicotine and is addictive.”In the UK, warning labels also inform consumers that nicotine pouches are “not risk-free” because they contain traces of tobacco-specific nitrosamines (TSNAs), cancer-causing compounds that are also present in cigarettes.Velo pouches have gained global popularity, including among Kenya’s youth. TikTok videos of young Kenyans using Velo have amassed millions of views, and academic research shows the product being is sold in schools.A draft report by a government taskforce, which was then leaked to the Examination, accuses tobacco companies of targeting young people. Fearing a new generation will become addicted to nicotine and that the pouches could be a gateway to smoking, the taskforce is calling for strict regulation of the products. Other politicians are demanding an outright ban.The revelations about BAT’s role in shaping health warnings in Kenya come amid an industry-wide drive to sell more “smoke-free” – yet still addictive – nicotine products across the globe.The global market for nicotine pouches, one of many “smoke-free” products, was $3bn (£2.36bn) in 2021. BAT views Kenya as one of its key “test markets” in low and middle-income countries, according to its financial presentations, and plans to make the country its base of operations for a rollout of the product across southern and eastern Africa.However, it isn’t clear how nicotine pouches affect human health over the long term.In September 2021, BAT’s managing director wrote to the Kenyan health ministry asking for permission for Lyft (as Velo was called when it first entered the market) to be sold with a warning covering just 10% of the pack. It said the “resumption of factory operations” hinged on this smaller warning being approved. “Your positive consideration of this request will allow us to operationalise our factory,” the letter said. The Ministry of Health agreed to allow warnings covering 15% of the front of the pack.In a statement, a BAT spokesperson said the product’s labelling provides “important safety information” and that the language clearly states that all nicotine pouches are for adults only and should “never be used by those who are underage”.“Like many other companies, we contribute to the public debate on issues that are important to our consumers, in particular tobacco harm reduction,” the spokesperson said.Velo nicotine pouches come in various flavours and are the only brand legally available in Kenya. Photograph: LWH/AlamyWhat are Velo pouches and do they harm health?Velo are white pouches filled with nicotine, flavouring, and plant fibres that are placed between the lip and gum to release a hit of nicotine. They are inspired by Snus, the Swedish moist tobacco product, but are tobacco-free. The pouches come in a range of flavours including “tropic breeze”, “urban vibe” and “ruby berry”. In Kenya, Velo costs 350 shillings (£1.69) for a small can containing 20 pouches, making them affordable for middle-class Kenyans.Velo are the only nicotine pouches that can be sold legally in Kenya, but others are smuggled in illegally.The science around the health effects of nicotine pouches is still emerging, and independent research is lacking because most studies so far have been commissioned by the tobacco industry. Industry research says the products expose users to fewer toxicants than smoking, but concludes that more studies are needed to determine if they reduce the risk of disease.Nicotine pouches can contain extremely high levels of nicotine and deliver the same amount of nicotine into the bloodstream as a cigarette. The long-term effects of nicotine include high blood pressure and increased risk of stroke and heart failure. Some studies show nicotine can damage developing babies’ brains and adversely affect the development of adolescent brains.The few independent studies that have been conducted on nicotine pouches have also revealed the presence of cancer-causing TSNAs in most brands. These are compounds that form naturally when tobacco is processed, in this case when nicotine is extracted to add to the pouches.BAT’s own research has found that Velo nicotine pouches contain the two most dangerous TSNAs, although it says they are not found in “quantifiable” levels.The American Cancer Society said that while there is evidence that exposure to TSNAs in higher doses (for example, as a result of smoking) is associated with cancer, there are no known long-term studies on exposure to low levels. Scientists from Germany’s Federal Institute for Risk Assessment said nicotine manufacturers should improve their processes to make sure carcinogenic substances such as TSNAs are not present.Nicotine pouches are fast-evolving products that vary widely and are likely to contain several other chemicals that might be cancer-causing, according to the American Cancer Society. BAT says nicotine pouches have a similar safety profile to nicotine replacement products, such as lozenges and chewing gum.A successful lobbying campaignBAT first launched its nicotine pouches into the Kenyan market in 2019.The company obtained its licence to sell the products through Kenya’s Pharmacy and Poisons Board, a health ministry department that regulates drugs and medicines. Under that licence, the pouches, then sold under the brand name Lyft, were only to be sold in drug stores.Velo products for sale in a bar in Nakuru, Kenya. Photograph: Sipa US/AlamyBut BAT and its vendors sold the pouches online and in shops. They advertised the pouches through social media influencers and giveaways at universities. Their popularity soared with young people, including children.A Kenyan DJ and a TV presenter were among the influencers hosted by BAT at the 2019 Formula One Grand Prix in Abu Dhabi, as part of the company’s sponsorship of the McLaren F1 team. BAT paid the social media team to post hashtags such as #GetLyfted, #LyftxMcLaren and #LyftKenya to followers.In September 2020, the Kenyan health ministry wrote to the Pharmacy and Poisons Board challenging its decision to license Lyft, which it said was also being sold in vending machines, in violation of the law. BAT said it has never sold its products in vending machines.The ministry asked for a comprehensive report on the circumstances that led to the Pharmacy and Poisons Board granting BAT a licence to sell its pouches in the first place. The Pharmacy and Poisons Board wrote to BAT Kenya in October 2020, saying Lyft should be sold only by pharmacies and must be withdrawn from retail stores and online marketplaces. It said the product must not be advertised.In response, BAT temporarily suspended Lyft sales. It told investors it would “continue to engage with the local authorities”.In January 2021, the health ministry wrote to BAT saying the pouches would now be subject to Kenya’s existing tobacco regulations, which require health warnings that cover about a third of the front of the packaging and half of the back. Before BAT suspended sales of Lyft they were being sold with significantly smaller warnings.“This is when heavy lobbying now started, letters were written and many meetings held in Afya House [the headquarters for the Kenyan health ministry],” a government public health official told the Examination on condition of anonymity.The key breakthrough came for BAT shortly after it wrote to the health ministry in September 2021 and threatened to pull investment from a new nicotine pouch factory it had pledged to build in Nairobi, which would serve east and south Africa.In the letter, Crispin Achola, BAT Kenya’s managing director, told the cabinet health secretary Mutahi Kagwe that “our resumption of factory operations and the sale of Lyft in Kenya hinges on the provision of appropriate text health warnings”.Achola drew Kagwe’s attention to a subclause in Kenya’s Tobacco Control Act of 2007 that allows the cabinet secretary discretion to alter the health warnings on products via a special directive.Initially, BAT had pledged more than $15m to build a new factory for the nicotine pouches.Less than a month after BAT made its threat about the investment, Kagwe permitted BAT to cut the size of the health warnings on the nicotine pouch packaging in half and said the only health warning it had to include was the words: “This product contains nicotine and is addictive”, with no mention of the presence of the cancer-causing toxicants.As a result, the products were given the green light to re-enter the Kenyan market in June 2022. This is when the pouches, rebranded to Velo, flooded back. The health ministry has not responded with a commentBAT was given special dispensation to sell nicotine pouches without standard-sized health warnings until July 2023. After that permission expired, the tobacco giant wrote to the health ministry in August asking for an indefinite exemption, “pending the development of specific regulations on this product and related categories”.The health ministry has not yet responded to BAT. Velo is still on sale although there are shortages in shops. In October and November 2023, multiple shipments of nicotine pouches were impounded at Jomo Kenyatta International Airport. It is unclear why but in total, almost 20 tonnes of the product have been seized.While BWT says its Velo pouches are targeted only at adults, experts say illegal sellers are pushing similar products in schools. Photograph: Andriy Popov/AlamyA hit among gen ZBAT says Velo pouches are targeted only at adult smokers or nicotine users, but experts argue that the products are popular among young Kenyans. This is despite smoking rates being low in that age group.As data on Velo sales is not made publicly available either by BAT or the Kenyan government, the number of customers, including of young people buying the product, is unknown.Preliminary data from an unpublished survey by Cyprian Mostert, an assistant professor of global health economics at Aga Khan University’s Brain and Mind Institute in Nairobi, indicates that the nicotine pouches are used mainly by gen Z (those born between 1997 and 2012). The pouches have become especially popular among urban youth, particularly among girls, the research indicates.“Teachers told us they [nicotine pouches] have already infiltrated the schooling system in Kenya, especially the secondary schools. There is a very drastic upswing into those cohorts because they are marketed as something cool,” Mostert says.“About 70% of this product is traded online. There are ‘pushers’, illegal guys operating at a community level, that can push these products directly to schools, and security guards that are working in many schools are also part of the pushers and introducing it to the children,” he says.The drivers of motorcycle taxis, called “boda boda” riders in Kenya, are pushing the products, Mostert says. He was told by a school district official interviewed for the study that teachers had faced disciplinary hearings for selling nicotine pouches to kids.“School principals are seeing an upswing in the consumption of the product because local traders are driving a misinformation campaign that it is a cool product that can make children feel calm,” he says.We make BAT feel its home in Africa is Kenya, which is so bad for the region and the entire generation we’re subjecting to addictionJoel Gitali, Kenya Tobacco Control AllianceIn a statement, BAT told the Examination that it works with retailers “to educate them on minimum age laws and conduct spot checks to ensure minimum age information notices are in place”.The government taskforce debating the legality of nicotine products is considering new laws that would regulate these products separately from cigarettes, as well as labelling that includes warnings of the health risks.Joel Gitali, the chair of the Kenya Tobacco Control Alliance, says the government is at a “crossroads”, where it must choose between public health and the economic benefits BAT claims the nicotine pouches will bring to Kenya.“Kenya is being misused and we have given these people a very good landing ground where they can operate and do anything,” he said. “We are making BAT feel that its home in Africa is Kenya, which is something that is so bad for the region and to the entire generation that we are subjecting to this kind of addiction. It must stop.”Additional reporting from Edwin Okoth

https://www.theguardian.com/global-development/2024/jan/23/how-big-tobacco-forced-kenya-to-temper-nicotine-pouch-warning-labels

Recommended For You