The president of the African Medical Association, Kgosi Letlape spoke to Christabel Ligami about nicotine addiction at the sidelines of the recent Middle East-Africa Health Forum 2016 in Dubai.

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Quitting smoking is not easy. Are there safe methods that can be adopted to help those addicted to nicotine?

The quickest and most effective way of delivering nicotine is through cigarettes, but it is also the most dangerous because when the tobacco burns it changes. The burning of tobacco results in by-products of over 7,000 chemicals. If you don’t heat the tobacco, you get different chemicals from those produced during combustion.

If you extract the nicotine without burning it, you then avoid more than 95 per cent of the harmful chemicals. Carbon monoxide is one of the by-products of combustion. People get addicted to the nicotine in the cigarettes, but there are safer ways of delivering the nicotine — by using e-cigarettes, or by sniffing it, using nicotine patches or gum.

There is debate on whether e-cigarettes really address the behavioural aspects of the addiction. What are your views?

Unlike a nicotine patch, which can only address the drug component, electronic cigarettes address the behavioural aspect. You use it, hold it, blow on it and inhale from it just like a cigarette and this mimicking satisfies the craving.

Why is nicotine so addictive?

It is addictive because of the nature of the chemical and because it is a stimulant. It gives a temporary high but it is strongly addictive because of the effect it has on the brain: It has a calming effect and makes smokers feel good. Studies show that this effect is felt more if nicotine is delivered through burning. Other studies show that if a cigarette smoker switches to e-cigarettes, they have a higher chance of quitting the habit.

Many policies have been proposed to regulate smoking and even ban tobacco use. Some have been adopted by governments while others have not. What is your take on this?

I support anything being done to reduce consumption of combustibles. But prohibition doesn’t work because cigarettes are still legal. This is why we need to promote the use of alternative products that are safe and less harmful.

The regulators talk about plain packaging and health warnings but governments should emphasise health information rather than warnings. Cigarette packaging should contain health information that lets people know, especially those addicted, that there are less harmful ways of getting your nicotine fix such as through e-cigarettes.

Why is there such resistance from governments to these policies?

There are many vested interests involved because the tobacco business is a big industry. It is a big contributor to government revenues in most economies in the world.

Governments are addicted to the taxes; the tobacco industry is addicted to the profits; smokers are addicted to nicotine and this is not going to change any time soon.

The emphasis should be on informing smokers about available alternatives to smoking cigarettes. The smoker should be made the star of the conversation and be the advocate of the change.

What is the role of the African Medical Association in the tobacco debate?
The African Medical Association is not a tobacco advocate but we support informative campaigns so that health workers are better informed about tobacco and nicotine.