SMOKE AND MIRRORS: Rethinking tobacco control in Cameroon

By Leslie Ngwa,
Tobacco has long been part of daily life in Cameroon. It is deeply embedded into cultural practices, supports rural economies, and influences personal choices. In 2022 alone, over 6,385 tonnes of tobacco were cultivated across more than 4,200 hectares of land, providing livelihoods for many, particularly in agricultural communities. 
At the same time, there is increasing awareness of the health risks associated with smoking. According to the Tobacco Atlas, smoking-related illnesses claim more than 4,500 lives annually in Cameroon, while second-hand smoke poses risks to millions more, especially children and non-smokers. The economic cost is also significant, with an estimated loss of 85.2 billion CFA francs each year. 
To address these concerns, the government of Cameroon has implemented a series of regulatory measures. These include health warnings on cigarette packs, restrictions on smoking in public spaces, and public education campaigns. These efforts demonstrate a strong commitment to public health while acknowledging the role tobacco continues to play in the country’s social and economic fabric. 

However, to make more meaningful progress, Cameroon must take the next step. This next step does not require banning tobacco entirely, but rather offering less harmful, and scientifically backed alternatives for adult smokers who are unable or unwilling to quit. Around the world, countries are shifting their approach by embracing innovation and empowering people with better choices, and the results are promising. 
Tobacco Harm Reduction, or THR, presents an opportunity for  Cameroon to reshape its tobacco control efforts. THR is based on a simple yet powerful idea: reducing the harmful effects of tobacco by giving adult smokers access to products that do not involve combustion. These products, which include heated tobacco, oral Nicotine pouches, and other smoke-free alternatives, are designed to reduce exposure to toxic substances that cause the most damage to health. 

Sweden offers a powerful example of what is possible. The country now has one of the lowest smoking rates in the world and is almost officially smoke-free, with fewer than 5.6 percent of adults using combustible tobacco. This achievement did not come from bans or stigmatization. It came from providing less harmful alternatives and empowering consumers to make informed choices. Cameroon can learn from this model by adapting it to our local context and realities. To support this shift, policymakers must ensure that fiscal and regulatory policies are aligned with public health goals. One major barrier today is that safer alternatives are often taxed at the same rate as combustible cigarettes.

This sends the wrong signal and discourages smokers from switching. Cameroon needs to adopt an excise tax structure that treats reduced-risk products differently and more favorably than cigarettes. Lower taxes on these products would encourage innovation, increase accessibility, and make the switch economically attractive for smokers. 
In parallel, regulation must be proportionate and evidence-based.  Applying the same rules to all nicotine products, regardless of risk, can confuse the public and reduce the effectiveness of harm reduction strategies. Regulations should be designed to protect young people while still supporting adult smokers who want to switch to less harmful alternatives. 
The way forward for Cameroon lies not in penalizing smokers, but in embracing innovation through reduced-risk products. It is essential to educate the public about the availability and benefits of these alternatives while fostering collaboration with key stakeholders advocating for a switch from combustible cigarettes to safer options. By promoting reduced-risk products, supporting cessation efforts, and engaging government, civil society, and the private sector, Cameroon can significantly reduce smoking-related harm while also preserving livelihoods and ensuring industry stability. 
This is a call to action. Policymakers must prioritize science over stigma. Cameroon has the chance to lead with a modern, balanced approach to tobacco control that protects health, empowers consumers, and fosters economic resilience. The focus should be on providing better options and the right information to 
those who need them most. Cameroon can protect its citizens and economy by choosing progress 
over prohibition. The time to act is now.