A Nigerian global health researcher has called for more current, Africa-led evidence on smoking, nicotine use and cessation to guide public health decisions across the continent.
Dr. Gabriel Oke, Secretary of the Expert Alliance for Tobacco Harm Reduction, made the call in reflections from the EATHR Connect and Collaborate Workshop held in Manila in October 2026, where clinicians, professors and policy specialists from Asia and the Pacific gathered to discuss tobacco harm reduction.
Oke said a patient’s words projected on screen at the workshop – “Doc, I know smoking is bad. But I cannot seem to stop” – underscored the human reality behind smoking statistics and the need for support systems that work.
He noted parallels between quit attempts in the Philippines and Nigeria. Figures shared at the workshop showed 45.5% of Filipino smokers tried to quit in the past year, with only 3.9% succeeding. Nigeria’s 2012 Global Adult Tobacco Survey showed a similar pattern, with 45.4% of smokers attempting to quit, about six in ten of them without assistance.
Oke said while the two surveys are not directly comparable, both point to a large number of people trying to quit without support. He also raised concern over the age of Nigeria’s data, saying 14 years is too long in a field where products, markets and youth use patterns are changing fast.
According to him, several African countries are already taking policy decisions on new nicotine products. Nigeria is working on standards for heated tobacco products, e-cigarettes and nicotine pouches, while Kenya is reviewing its legal framework for such products. He said such decisions must be informed by up-to-date evidence, with gaps clearly acknowledged.
He cited the World Health Organization’s 2025 global trends report, which puts tobacco use in the WHO African Region at about 9.5% in 2024 – lower than other regions – but warned that population growth means prevalence rates alone do not tell the full story of people affected.
Gap in training of health workers
Oke, who has researched healthcare professionals’ knowledge on smoking cessation, cited his survey of 263 medical students in Kigali, Rwanda. The study found only 27% knew that vaping is considered less harmful than smoking and fewer than 17% recognised it as a potential aid to quitting. About half had already seen patients seeking help to stop smoking, while most wanted more training.
He said healthcare professionals do not need to promote specific products, but need balanced, accurate information to answer patients’ questions and explain where evidence is strong or still uncertain.
Case studies for Africa
At the Manila workshop, Oke co-moderated a session on developing an evidence agenda. He said Nigeria, Kenya and South Africa emerged as potential case studies.
He pointed to South Africa’s 2020 cigarette sales ban during COVID-19 lockdown, where a University of Cape Town survey of over 16,000 people found over 90% of smokers continued buying cigarettes through informal vendors as formal retail collapsed.
He proposed short country evidence briefs for Nigeria, Kenya, South Africa and Rwanda, multi-country research on health professionals’ knowledge, and a balanced assessment of what South Africa’s lockdown revealed about illicit tobacco markets.
Oke stressed that such research must be done with local researchers, clinicians, policymakers and people with lived experience of smoking, be transparent about funding and conflicts of interest, and uphold safeguards under Article 5.3 of the WHO Framework Convention on Tobacco Control against tobacco industry interference.
“African researchers should have the resources to investigate local questions, healthcare professionals should receive appropriate training, and policymakers should have access to evidence that reflects the realities of the people their decisions affect,” he said.
Oke is a global health researcher, Fellow of the Royal Society for Public Health, UK, member of Scientific Insights in Harm Reduction in Africa, and founder of THRJourno. He has 32 publications and has moderated sessions at the Asia Forum on Nicotine.
