On October 18, 100 tobacco control experts called on the World Health Organization (WHO) to accept the reality of safer nicotine alternatives.
The letter, which harshly criticizes the WHO for its hostile stance against tobacco harm reduction (THR), arrives ahead of a gathering of the 182 countries that belong to the health agency’s Framework Convention on Tobacco Control (FCTC). The meeting, the Conference of the Parties (COP), happens every two years. In 2021, it’ll be held in early November—and discussions of THR are not explicitly on the agenda.
“There are many experts who feel strongly about these issues and believe in sound science and good policy,” said Clive Bates, the former director of Action on Smoking and Health (UK), who published the letter on his blog.
Together, Bates and his colleagues—including Abigail Friedman of Yale, Cheryl Healton of NYU and David Nutt of Imperial College London, among many others—outline how THR “presents significant public health opportunities” if properly embraced.
They list six recommendations for the WHO: Make THR an element of a global plan to combat noncommunicable diseases; assess safer nicotine alternatives for smokers, would-be smokers and adolescents; require policy proposals to reflect the unintended consequences of strategies like prohibition; give harm-reduction proponents, like consumer advocates, a voice; create an independent review of the WHO’s approach to tobacco control; and appropriately address malpractice by the tobacco industry without forming barriers to the emergence of reduced-risk products.
From the agency’s perspective, it appears, there’s no real difference between smoking and vaping.
The FCTC was adopted by the WHO in 2003, prior to the rise of e-cigarettes. The treaty covers more than 90 percent of the planet’s population. Its main guidelines, often referred to as MPOWER, include monitoring “tobacco use and prevention policies”; protecting “people from tobacco smoke”; offering “help to quit tobacco use”; warning “people about the dangers of tobacco”; enforcing “bans on tobacco advertising, promotion and sponsorship”; and raising “taxes on tobacco.”
Yet despite the fact that countless public health authorities have stated vaping to be significantly less harmful than combustible cigarettes, the WHO seems to want to apply those measures to all nicotine products. From the agency’s perspective, it appears, there’s no real difference between smoking and vaping: Leading figures there have long insisted, for example, that the scientific evidence on e-cigarettes is “inconclusive,” and have maintained that “switching from conventional tobacco products to e-cigarettes is not quitting.” They have repeatedly asserted such a stance, even as countries such as Japan have seen record decreases in combustible smoking with safer options available on the market.
Vocal THR supporters, consumers and drug-war critics have frequently criticized the WHO for pushing prohibition or draconian regulations that would hinder smokers from switching to safer nicotine products, like vapes or forms of smokeless tobacco. They’ve warned of the philanthropic influence of billionaires like Michael Bloomberg, the WHO’s global ambassador for noncommunicable diseases and injuries and a funder of the agency, who has used the power of his nonprofit to push for vape bans—particularly in lower- and middle-income countries, where governments are more susceptible to outside financial interference and where the majority of tobacco users live.
They’ve also pointed out that the WHO’s definition of “tobacco control” includes incorporating harm reduction into its policy.
Plenty of scholars and activists “don’t have the megaphones that come with Bloomberg funding and have no way to attend the WHO meetings,” Bates told Filter. “But they do want their views to be heard, and to lay down some facts and analysis that will help parties to the FCTC do the right thing for the right reasons.”
“Writing these letters,” he continued, “allows knowledgeable individuals to have their say and contribute to the convention through direct communication with delegates from a distance.”
Photograph by United States Mission Geneva via Flickr/Creative Commons 2.0