Postponing its 10th Conference of the Parties (COP10) to the Framework Convention on Tobacco Control hasn’t stopped the World Health Organization (WHO) from doubling down on its efforts to ban safer alternatives to cigarettes.
Originally planned for November, COP10 will now begin on February 5 in Panama City. All the evidence has pointed to the WHO using the event to advance draconian anti-harm reduction proposals, which would have global policy impacts.
In case we were unsure, the agency declares in a December 14 press release that nicotine vapes are “harmful to health,” although “long-term health effects are not fully understood.” It states that some substances found in e-liquids “are known to cause cancer and increase the risk of heart and lung disorders,” without adding that they are present in such low doses as to be inconsequential to human health.
The WHO approvingly notes that 34 countries already ban vaping products, encouraging them to “ensure strong enforcement.”
The release ignores the critical reality that vapes are exponentially less harmful than the cigarettes they replace, a fact established beyond doubt by years of evidence.
Instead, the WHO approvingly notes that 34 countries already ban vaping products, encouraging them to “strengthen implementation” and “ensure strong enforcement.”
“Based on the current evidence, it is not recommended that governments permit sale of e-cigarettes as consumer products in pursuit of a [smoking] cessation objective,” the agency states, completely erasing the experiences of scores of millions of people worldwide who have quit deadly cigarettes through a consumer-driven revolution.
For those recalcitrant governments that do pursue smoking cessation through vapes, the WHO urges them to treat these products as medicinal devices only—a policy that has been tried, with disastrous outcomes, in Australia. And it wants authorities to restrict a myriad of features that help adults quit smoking, such as flavors and varied nicotine levels. It calls for vape taxes that would remove financial incentives for people to choose harm reduction options over cigarettes.
The agency talks about reducing the “appeal” of vapes to “the population”—which presumably means deterring the entire population, including the estimated 1.3 billion adults who smoke.
For governments (and consumers) across the world, the WHO’s advice should come with a flashing health warning. Its stance in this area is chock-full of cherry-picked alarmism and disregard for the lifesaving realities of tobacco harm reduction. Its position—a bitter disappointment when the WHO supports harm reduction for other drugs—comes right from the top.
Slim hopes of averting more crackdowns will rest with delegates from countries that have reaped rewards by rejecting the WHO’s anti-harm reduction message.
“Kids are being recruited and trapped at an early age to use e-cigarettes and may get hooked to nicotine,” said Dr Tedros Adhanom Ghebreyesus, WHO director-general, in the release. “I urge countries to implement strict measures to prevent uptake to protect their citizens, especially their children and young people.”
In inflating risks of youth vaping while ignoring the needs of populations that are actually dying of smoking, his words echo the talking points of Bloomberg-funded anti-vaping organizations, of which the WHO is one.
Groups representing consumers of safer nicotine products are entirely excluded from COP10. So their slim hopes of averting more crackdowns will rest with delegates from countries that have reaped public health rewards by rejecting the WHO’s anti-harm reduction message.
Delegates from the United Kingdom and New Zealand, for example—both of which embrace vapes as a harm reduction tool—will be able to inform signatories of the WHO’s tobacco control treaty of their successes in reducing smoking. Sweden, with snus, and Japan, with heated tobacco products, have also made dramatic progress by supporting safer alternatives.
UK public health groups acknowledge vapes as harm reduction and the government is embracing their use as a tool to help adults transition to safer products. In a recent UK Government consultation, the Royal College of Physicians (RCP) urged policymakers to refrain from “the wholesale limiting of [vape flavors] accessible to adults.” The RCP in fact, “supports the use of a range of [flavors] including fruit [flavors],” and finds their use “an integral part of the effectiveness of vaping as a quit aid.”
In April 2023 the UK government vowed to give away vape starter kits to 1 million people who smoke, with local authorities now beginning to distribute them.
But even in the United States, where federal health agencies are themselves guilty of misinformation, there’s acknowledgement that vapes are safer alternatives.
The notoriously anti-vaping Centers for Disease Control and Prevention has finally admitted that vapes are “less harmful than regular cigarettes,” with “aerosol generally [containing] fewer toxic chemicals” than combustible cigarette smoke. The Food and Drug Administration has remarked that “transitioning completely from using cigarettes to an e-cigarette would reduce the risk of exposure to harmful chemicals.”
Smoking kills 8 million people per year. The WHO has betrayed its mission by recommending prohibition of products which can reduce that toll.
The FDA has even authorized the sale of a handful of vaping products, finding them to be “appropriate for the protection of public health.” The FDA notes the authorized products offer a “likely benefit” for adults who smoke.
The notion of the US delegation helping to curb the WHO’s excesses may seem outlandish to beleaguered American tobacco harm reduction advocates, but we can hope.
Governments should roundly reject the WHO’s advice. Although sensible regulation to reduce underage vaping is worthwhile, partial or total prohibition can only be detrimental to public health. Moreover, permitting commercial tobacco harm reduction products costs governments nothing—whereas the toll of death and disease from smoking strains health systems and budgets worldwide.
Smoking kills 8 million people per year. The WHO has taken leave of its senses and betrayed its mission by recommending prohibition of products which can reduce that toll.
Photograph by Zach Peterson via Flickr/Creative Commons 2.0
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