Sadly nly is right. The only other option to change this is the ngx_headers_more module, but that still requires a rebuild. I suppose that way you at least get a little more functionality for your troubles.
You also need that module to do per URI/path/regex match headers properly, because add_header + location blocks are woefully insufficient thanks to the way they are processed. This is one reason I gave up on CSP under nginx.
As if turning it off helps. Nginx is so popular, attackers would just try Nginx-specific exploits right after trying Apache ones even if they don't know for sure whether you are running Nginx.