Methods of Tobacco Harm Reduction Among Smokers in Malawi: Case Study of Chitipa, Ntcheu And Balaka Districts

Abstract The aim of the study was to investigate the methods of tobacco harm reduction products used by smokers in Malawi, in an attempt to reduce tobacco harm. The study employed a cross-sectional survey, with both quantitative and qualitative data collection, in 3 districts, one from each region across Malawi. Participants were recruited using the technique of snowball sampling. 1,258 current and ex-smokers were recruited, age range 15–55 years. The sample size for each district was calculated using the standard formula with a 95% confidence interval or significance of p = 0.05. Tobacco harm reduction products, also known as safer nicotine products, are not widely available in Malawi; as such their use is not statistically significant at 5%. However, the following resources were used to reduce tobacco harm: fruits like Malambe (Baobab), Banana, Masau (Jujube), Mtera (local herbs), sweets, chewing gum, fried maize and milk. Solutions: cigarette filters mixed with water, a mixture of pig milk, tobacco and drinking water. In addition, ngirimbo and chingambwe were used in a smokeless way to reduce tobacco harm. Across Malawi, smokers use local tobacco harm reduction products compared to safer nicotine products. This is compounded by the absence of information on safer nicotine products, a lack of service providers, poverty and use of local smokeless tobacco.