You may not have heard it, but the final lap bell has been rung in the race to inflict maximum damage on tobacco harm reduction at a World Health Organization (WHO) meeting later this year. From here on in, it’s a sprint to the finish. If the WHO is successful, public health worldwide will be the loser.
At the end of November, Panama City will host the 10th Session of the Conference of the Parties (COP10) to the WHO Framework Convention on Tobacco Control (FCTC).
The FCTC is an international treaty, signed and ratified by 182 countries, which was originally drafted to address the harms of combustible tobacco. In recent years, however, those administering the treaty—the FCTC Secretariat and Bureau—have increasingly turned their guns on vapes and other reduced-risk products, such as heated tobacco and nicotine pouches. And many national governments, especially in Africa, Asia and other parts of the Global South, automatically adhere to the WHO’s positions.
The biennial COP was last held in-person in 2018. COVID-19 saw the 2020 gathering postponed until a virtual iteration in 2021—when all decisions were kicked down the road until this year, due to it being considered suboptimal to hold serious discussions remotely.
That does not mean that the WHO’s well-established hostility to tobacco harm reduction was parked for the last five years. On the contrary, FCTC administrators have been steadily building up a portfolio of cherry-picked evidence and shonky reports from sources carefully selected for their ideological opposition to anything but quit-or-die tobacco control policies.
One proposal seeks to redefine “smoking cessation” as quitting not only smoking, but all nicotine use.
Numerous consumer advocacy organizations have recognized the threats which could be posed at the COP10 meeting. Published WHO reports have suggested banning open vaping systems; prohibiting all the non-tobacco e-liquid flavors which most people who use vapes to quit smoking prefer; banning nicotine salts in liquids; and regulating vapes according to nicotine emissions over time, ultimately replacing the wide range of devices currently available with homogenized options that don’t meet people’s diverse needs.
Further WHO reports have recommended redefining “smoke” to include “visible aerosols deriving in whole or in part from thermally driven chemical reactions”—gases which are certainly not smoke. This verbal subterfuge would drag vaping firmly into the remit of the FCTC treaty. A similar proposal seeks to redefine “smoking cessation” as quitting not only smoking, but all nicotine use.
Another recent WHO report recommended “that regulations of tobacco products [be] extended and applied to all forms of nicotine and tobacco products and not restricted to conventional cigarettes.” This would subject safer nicotine products to every onerous restriction currently applied to combustible tobacco: taxation at the same rate as cigarettes; public vaping bans, both indoors and outdoors; graphic health warnings; prohibition of advertising, and plain packaging.
Until now, the runup to COP10 has felt like a phony war. The WHO has been patting itself on the back for its 75th anniversary—and at the end of May, just before WHO No Tobacco Day, celebrated 20 years since the 2003 signing of the FCTC treaty.
With these events out of the way, harm reduction deniers have rolled up their sleeves, and are now working tirelessly towards the eradication of products which have driven dramatic declines in smoking rates wherever they have been liberally regulated.
At the beginning of June, the WHO Eastern Mediterranean region held a third meeting on taxation of tobacco and nicotine products. Two weeks later, another secret meeting was held in Geneva on the issue of flavors, which will likely influence preparations for COP10 by the WHO and FCTC Secretariat in persuading delegates to impose bans.
Immediately after that, the WHO’s misnamed Global Consultation on Novel and Emerging Nicotine and Tobacco Products followed, discussing potential regulations on the whole range of safer nicotine products, which will almost certainly lead to more policy recommendations ahead of COP10. Naturally, only those fully committed to prohibition were invited.
In the coming weeks, the ninth report of the WHO study group on tobacco product regulation (TobReg9) will be published. This will finally reveal the full extent of the assault on safer nicotine products planned by the WHO for November—no doubt containing many of the draconian proposals already seen in interim documents.
If the WHO’s inexorable march toward depriving the world of products which have helped tens of millions quit smoking is to be obstructed, the time to try is now.
Then it is just a matter of cramming them all into the COP10 agenda. The provisional agenda, which lists vague details of items to be discussed, has already been posted online; the annotated version will carry much more information and is required to be made public in September. Pre-COP meetings of the WHO regional groups will take place soon after, to further cement a unified approach.
In other words, despite November being months away, time is rapidly running out.
The only way that the public, the safer nicotine trade and tobacco harm reduction advocates can have an impact on events in Panama is by petitioning elected representatives and government officials in their own countries.
Decisions at COP10 are made by the national delegations, so it is crucial to engage at a national level with key policymakers and potential delegates. With the clock ticking, this action is becoming more urgent by the day. As we speak, national delegations and country positions are already being decided. The registration process has been open since early May.
If the WHO’s inexorable march toward depriving the world of products which have helped tens of millions quit smoking is to be obstructed, the time to try is now.
Update, July 13: This article has been updated to reflect the publication of the provisional COP10 agenda.
Photograph by Agê Barros via Unsplash