Kenya's pharmacists are on the front line of tobacco harm reduction. HRSK examines how they can transform health outcomes for millions of Kenyans.
When HRSK presented at the Pharmaceutical Society of Kenya's 45th Annual Scientific Conference in June 2025, the theme — "Beyond the practice: Pharmacists innovating for accessible, quality and impactful healthcare" — could not have been more apt for our message. Pharmacists are uniquely positioned to transform tobacco harm reduction in Kenya. Yet this potential remains largely untapped.
With over 5,000 registered pharmacists in Kenya and thousands more pharmaceutical technologists operating across community pharmacies, hospital dispensaries, and health centres throughout the country, the pharmacy profession represents an extraordinary — and underutilised — resource for tobacco cessation and harm reduction at population scale.
Why Pharmacists Are Ideally Placed for Tobacco Harm Reduction
Pharmacists enjoy a unique set of characteristics that make them natural tobacco harm reduction champions:
- Accessibility: Community pharmacies are often the most accessible healthcare touchpoint for many Kenyans — no appointment needed, open longer hours, and physically present in communities where primary care facilities may be distant.
- Trust: Pharmacists are among the most trusted healthcare professionals. People regularly share health concerns with their pharmacist that they might hesitate to raise with a doctor.
- Regular contact: Smokers with chronic conditions — hypertension, diabetes, respiratory disease — visit pharmacies repeatedly to collect medications, creating multiple opportunities for brief tobacco interventions.
- NRT dispensing authority: Pharmacists already dispense nicotine replacement therapy, giving them a natural entry point into cessation support conversations.
- Clinical knowledge: Pharmacists understand the pharmacology of nicotine, the mechanisms of NRT, and the drug interactions and contraindications relevant to cessation medications.
The Evidence for Pharmacy-Based Tobacco Interventions
The global evidence base for pharmacy-based tobacco interventions is substantial and growing:
- Systematic reviews demonstrate that pharmacist-delivered brief advice to quit smoking — even when it takes only 3–5 minutes — significantly increases quit attempts compared to no intervention.
- Pharmacist-led extended cessation support programmes, involving regular follow-up appointments and medication management, achieve quit rates of 20–40% at 12 months — comparable to specialist cessation clinics.
- Studies from Australia, the UK, and the United States show that pharmacy-based NRT programmes significantly increase NRT uptake among lower-income populations who would not otherwise access cessation support.
- In countries where pharmacists have been trained to counsel on both NRT and reduced-risk nicotine products, the proportion of smokers accessing cessation support has increased substantially.
The Very Brief Advice (VBA) Framework
HRSK promotes the Very Brief Advice framework — a structured, evidence-based approach to tobacco intervention that any healthcare professional, including pharmacists, can use in routine practice in under five minutes. The three components are:
- ASK: "Do you smoke?" — Every patient interaction is an opportunity to ask.
- ADVISE: "The best thing you can do for your health is to stop smoking, and I can help you with that." — Clear, non-judgmental, personalised advice.
- ACT: Offer or refer to cessation support — NRT, prescription medications, a brief intervention, or a referral to a specialist service.
This simple three-step approach, when systematically implemented across all pharmacy encounters, could reach millions of Kenyan smokers with an evidence-based invitation to quit or reduce harm — at minimal cost and with no additional infrastructure required.
Nicotine Replacement Therapy: The Pharmacist's Core Tool
NRT remains the most widely available, best-evidenced pharmacotherapy for tobacco cessation. The full range of NRT formats — patches, gum, lozenges, inhalers, and nasal sprays — addresses the diverse needs of different smokers. Pharmacists' core competencies in NRT include:
- Advising on appropriate product selection based on smoking patterns and patient preference
- Counselling on correct use (a common reason for NRT failure is incorrect use)
- Combination NRT (patch plus short-acting form) for heavier smokers
- Managing side effects and maintaining patient motivation
- Tapering NRT appropriately to support long-term cessation
Evolving Tools: Reduced-Risk Nicotine Products
As HRSK discussed at the PSK conference, pharmacists must also be equipped to counsel patients on the growing range of reduced-risk nicotine products, including heated tobacco products and nicotine pouches. While these are not cessation medications in the traditional sense, they represent an important option for smokers who have been unable to quit through conventional means. Pharmacists who understand the relative risks of these products — and who can provide accurate, non-judgmental information — are better placed to support patients towards better health outcomes.
Barriers and How HRSK Is Addressing Them
Despite this enormous potential, pharmacy-based tobacco harm reduction in Kenya faces real challenges:
- Training gap: Many pharmacists report feeling undertrained in tobacco cessation counselling. HRSK has begun delivering CPD-accredited tobacco harm reduction training through pharmacy associations.
- Time pressures: Community pharmacies are busy environments. HRSK's VBA framework is specifically designed to be brief and practical for real-world pharmacy settings.
- Awareness of full product range: Knowledge of the full NRT product range and of reduced-risk nicotine products is variable. HRSK's training updates pharmacists on the current evidence base.
- Regulatory uncertainty: Lack of clear regulatory guidance on reduced-risk nicotine products creates uncertainty for pharmacists. HRSK advocates for clear, proportionate regulation.
"The pharmacy profession has a once-in-a-generation opportunity to lead the transformation of tobacco-related health in Kenya. With the right training, tools, and policy support, pharmacists can save thousands of lives annually. HRSK is committed to being their partner in this mission." — Dr. Michael Kariuki, HRSK
HRSK and the Pharmacy Profession
HRSK's engagement with the Pharmaceutical Society of Kenya, the Kenya Pharmaceutical Association, and pharmacy training institutions is a cornerstone of our harm reduction strategy. We provide:
- Accredited CPD training on tobacco harm reduction for pharmacists and pharmaceutical technologists
- Educational materials for community pharmacy waiting areas
- Advocacy for NRT on Kenya's essential medicines list at affordable prices
- Collaboration on pharmacy-based research to build the Kenyan evidence base for pharmacy interventions
If you are a pharmacist, pharmaceutical technologist, or pharmacy educator interested in partnering with HRSK, we would love to hear from you. Contact us at [email protected].
