Vietnam has a big-time smoking problem. A huge proportion of men, particularly—44.3 percent, by one estimate—smoke cigarettes. Smoking kills more than 100,000 people a year in Vietnam, according to the World Health Organization. Tobacco-related diseases also contribute to rising health care costs in a country where, despite rapid economic growth, per capita income remains below $5,000 a year.
Nevertheless, Vietnam’s National Assembly voted in November 2024 to ban nicotine vapes, which help drive down smoking rates in those countries where they are available. For people who smoke and cannot or will not quit nicotine, vaping is a far safer way to get it.
Smoking kills; vaping, as best as we can tell, does not.
So why did Vietnam ban vapes? A cynic might say that lawmakers were trying to protect Vinataba, the government-owned tobacco company, from a competitive threat. Vinataba controls about two-thirds of the cigarette market.
Disinformation from the Bloomberg network and from the WHO played a role. The WHO is a key cog in the Bloomberg machine.
But some credit—or blame—for the vaping ban surely belongs to Michael Bloomberg, the billionaire American philanthropist whose foundation supports an influential global network of anti-tobacco groups, including the World Health Organization. These groups oppose vaping as well as smoking, not just in Vietnam but in more than 50 low- and middle-income countries, from Argentina to Zambia.
The Bloomberg-funded crusade against vaping has scored big wins in some of these countries over the years. Brazil became one of the world’s first countries to ban vape sales in 2009. A decade later, India did so by executive order. At about the same time as Vietnam acted, Mexico enshrined a complete ban on nicotine vapes in its constitution.
Unsurprisingly, illicit vape markets have flourished in all those countries.
Vapes are advertised on Instagram and WhatsApp in Brazil, sold by brick-and-mortar retailers in India and available on street corners in Mexico, where experts say drug trafficking organizations are trying to capture the market.
Vapes, like drugs in general, will remain available where there is demand. But problems with illicit markets include that consumers don’t know what they are buying. Unregulated manufacturers and retailers have little incentive to adhere to quality controls or to age restrictions, when youth use was cited as a justification for Vietnam’s ban. Misinformation about vapes, which dissuades people from switching, remains widespread, and those messages are only reinforced when governments impose prohibition.
All of this was known—or should have been—as Vietnam debated its vape ban.
It’s difficult from afar to understand how and why lawmakers ignored or glossed over the evidence that vaping bans don’t work. But disinformation from the Bloomberg network and from the WHO played a role. The WHO is a key cog in the Bloomberg machine, as I’ve reported.
According to Vietnamnet Global, a popular news site, an official from Vietnam’s ministry of health said at an October 2024 seminar that “no scientific evidence supports the claim that e-cigarettes or heated tobacco products reduce harm or aid in quitting smoking.” This is patently false.
The ministry official is also quoted as saying that “the notion that e-cigarettes are 95 percent less harmful than traditional cigarettes, often quoted by a small group of experts, stems from a study funded by the tobacco industry and lacks scientific credibility.” This, too, is false: The 95 percent figure, which is admittedly a rough estimate, came from the United Kingdom’s leading public health agency.
The Bloomberg team has enjoyed a “deep collaboration with the government … in Vietnam,” Dr. Kelly Henning of Bloomberg Philanthropies wrote in a blog post, since deleted.
Why did the ministry get things so wrong?
Clive Bates, an advocate for tobacco harm reduction, wrote on a nicotine Listserv:
It is inconceivable to me that the Ministry would have a tobacco control seminar and WHO and its Bloomberg funded “partners” would not be present. So it is difficult not to conclude that they have promoted, passively or actively, these blatant falsehoods.
Vietnam is one of 10 priority countries identified by the Bloomberg Initiative to Reduce Tobacco Use. And the Bloomberg team has enjoyed a “deep collaboration with the government and local organizations in Vietnam,” Dr. Kelly Henning, who leads Bloomberg Philanthropies’ public health work, wrote in a blog post, since deleted, after a visit to Vietnam in 2018.
Bloomberg and its allies cheered Vietnam’s vape ban.
Under the headline “Vietnam Acts Decisively to Protect Youth From Heated Tobacco Products and E-Cigarettes,” Vital Strategies—a nonprofit focused on global health, which supports harm reduction with other drugs—characterized the ban as a victory over the tobacco industry. Sandra Mullin, a senior vice president at Vital Strategies, is quoted as saying: “The government of Vietnam is to be commended for this life-saving measure.”
Vital Strategies received more than $43m for its tobacco work from Bloomberg Philanthropies in 2021 and 2022, according to the foundation’s income tax return. Bloomberg is Vital Strategies’ biggest funder, by far.
Angela Pratt, the WHO’s representative in Vietnam, wrote on social media: “This is a vote for health, especially the health of Vietnam’s young people.” Dr Tedros Adhanom Ghebreyesus, the WHO’s director-general, chimed in to say: “Congratulations, #Vietnam, on making this bold decision to protect your citizens, especially the young ones, from vaping and heated tobacco products.”
When people are given the option to switch to vapes, millions do. The Bloomberg network wants to eliminate that option.
Bloomberg Philanthropies gave the WHO more than $18m for its anti-tobacco work in 2021 and 2022, tax filings show. WHO officials have said that Bloomberg’s money helps them implement their programs but does not affect policy making.
Not to be outdone, the Campaign for Tobacco-Free Kids published a statement “commending the Vietnamese government for prioritizing the health and well-being of youth.” The campaign had nothing to say about the 16 million adults who smoke in Vietnam and could benefit from access to safer nicotine alternatives.
Bloomberg Philanthropies gave more than $40 million to the Campaign for Tobacco Free Kids in 2021 and 2022 for its tobacco work, and tens of millions more for other projects. It is the campaign’s biggest donor.
All of this would be laughable if the life-and-death stakes were not so high.
Jonathan Foulds, a professor of public health at Penn State and smoking cessation expert, wrote on social media that Vietnam’s decision, “to leave cigarettes as the monopoly legal source of nicotine is to negligently cause excess deaths. This is public health ignorance at its worst.”
He’s got good reason to be concerned: Peer-reviewed studies in the United States, funded by the National Institutes of Health, have found that bans or restrictions on vape sales are associated with increases in smoking. When people are given the option to switch to vapes, millions do. The Bloomberg network wants to eliminate that option.
The most powerful evidence that bans on safer nicotine products do more harm than good comes from countries that have taken the opposite approach. They have permitted and, in some cases, promoted safer nicotine products, including vapes, oral tobacco and devices that deliver nicotine by heating tobacco, as opposed to burning it.
In Sweden, where people get their nicotine from smoke-free pouches called snus, smoking has nearly disappeared. In Japan, cigarette sales have fallen by more than half, as people switch to heat-not-burn devices. New Zealand, where vapes are legal—and the government encourages people who smoke to switch—is on track to reduce its smoking rate to below 5 percent.
None of this evidence seems to matter to Bloomberg Philanthropies and its allies. The foundation is accountable to no one and has been unwilling to listen to critics.
Bloomberg Philanthropies, Vital Strategies and the Campaign for Tobacco-Free Kids did not respond to Filter’s interview requests for this story.
Incredibly, Angela Pratt, the WHO’s representative in Vietnam, told Filter that “there is no evidence that these products help people to give up smoking tobacco.”
The WHO office in Vietnam responded via email to several questions.
Angela Pratt, the WHO’s representative in Vietnam, said that “new nicotine and tobacco products are not safe, and they are not healthy.” But this ignores the critical comparison with the deadly combustible tobacco they can replace.
She also said, correctly enough, that “regulating or restricting these products is extremely difficult.”
Pratt spouted some nonsense, too. Incredibly, she said that “there is no evidence that these products help people to give up smoking tobacco.”
No evidence? The UK’s National Health Service says that “you are roughly twice as likely to quit smoking if you use a nicotine vape compared with other nicotine replacement products, like patches or gum.” Consider, too, this summary of numerous studies from the trusted Cochrane group of health researchers, as well as the testimony of countless people who say vaping helped them to quit smoking.
Facts and evidence, it’s clear, are again being cast aside in the debate about smoking and vaping. People who smoke—an estimated 1.3 billion of them, most living in low- and middle-income countries—pay the price.
Photograph of a man smoking in Hanoi, Vietnam, by Clemence B. via Flickr/Creative Commons 2.0