Cancer has been a constant presence in my life. My mom had breast cancer. My grandma had cervical cancer. My aunt survived breast cancer and skin cancer—then got bone cancer, living with a level of pain I will never forget, before she died. Several of my family members and friends have had lung cancer or other forms of the disease.
Most of those people in my life smoked—a significant risk factor for many cancers besides the most obvious ones. Only a couple of them survived cancer, which means I’ve become familiar with premature death and the long-term emotional and financial strains families are left with.
So when World Cancer Day takes place on February 4 each year, it isn’t a meaningless awareness campaign to me. It’s personal.
As I watch entities like the World Health Organization (WHO) mark World Cancer Day, despite willfully spreading misinformation about things that can reduce cancer risk, I find myself lost in dark anger. I know that more people will die because they don’t know the truth.
Public health organizations’ messaging should make it easier, not harder, for people to reduce their risk of early death.
People need to know that it is the smoke from combustible tobacco, not the nicotine, that greatly increases cancer risk. People need to know that quitting smoking at any age, by any means, has health benefits.
Public health organizations’ messaging and policy recommendations should make it easier, not harder, for people to reduce their risk of early death. The WHO’s constant blurring of a crucial distinction—between deadly combustible tobacco and the safer nicotine products that have helped millions quit smoking—does the opposite.
A recent example comes from the WHO’s International Agency for Research on Cancer (IARC) and the fifth edition of its European Code Against Cancer. Released to the medical community in late 2025, it’s due to be presented to the public this World Cancer Day. It contains drastic changes in its messaging about smoking and nicotine.
In the European Code’s 2014 fourth edition, the tobacco guidance included the basic recommendation of “Do not smoke. Do not use any form of tobacco.” But what made it extra helpful was that it anticipated questions people might have and answered them in plain language. It accurately explained that it’s not nicotine that causes cancer, but exposure to carcinogens in combustible tobacco.
The fourth edition also addressed nicotine vaping with a degree of nuance. While stating that “Long term safety is unknown at present” and raising concerns about potential youth use, it said that vaping “is expected to have a lower risk of disease and death than tobacco smoking,” due to the absence of combustion. If people switch to vapes, it added, that has “the potential to reduce the enormous burden of disease and death caused by tobacco smoking.”
This is not some minor editorial adjustment. It fundamentally changes what the public will understand.
Compare that with what the European Code’s fifth edition emphasizes. Its headline guidance on smoking is short and misleading: “Do not smoke. Do not use any form of tobacco or vaping products. If you smoke, you should quit.”
Smoke and vapor are now treated as if they belong under the same warning label, without the explanatory details previously provided.
This is not some minor editorial adjustment. It fundamentally changes what the public will understand. When you remove the nuance and the “why,” and keep only the “don’t,” people will be led to believe that vaping and smoking are equally harmful, which is unequivocally false.
It doesn’t stop at individual advice. The fifth edition policy brief calls for measures such as heavy taxation—”All tobacco products should be taxed in a comparable way as appropriate, in particular where the risk of substitution exists.”—and steps to “restrict the availability and accessibility of tobacco products.” And it explicitly says that policymakers should “Extend such regulations to apply to all tobacco products, electronic cigarettes and all novel tobacco and nicotine-containing products.”
The document states that products like vapes and pouches are “relatively new,” and that “further research is needed to understand their potential links to cancer.” Yet it doesn’t mention that no cancer link has been proven to date, despite the best efforts of some researchers. It completely ignores these products’ role in smoking cessation. It just goes ahead and includes them in its blanket policy recommendations.
When institutions conflate nicotine and smoking, they harden confusion into common knowledge; myths become facts. One of the most damaging misperceptions I’ve seen, widespread among the public and among clinicians, is the belief that nicotine causes cancer. The consequence is that some people will continue to smoke instead of trying a much safer alternative.
If the WHO were to include people who use nicotine in the conversation, it would find it harder to ignore our experiences and our needs.
The WHO’s framing of harm reduction communication adds another layer of confusion by arguing that nicotine companies “cloak” their marketing in “the public health language of harm reduction.”
Regardless of what companies do, harm reduction is not a tobacco-industry invention. It’s a longstanding public health framework that the WHO supports in other areas of drug use. This framework acknowledges that drug use will happen, but that public health efforts can still reduce death and disease by making it safer. The public deserves balance: skepticism about marketing claims, paired with truthful risk communication that keeps the focus on whatever helps save the lives of people who smoke.
Harm reduction is also a movement—led by and centered on the agency of directly impacted people. If the WHO were to include people who use nicotine in the conversation, it would find it harder to ignore our experiences and our needs.
The WHO is already aware, but chooses to obscure, that modern vapor products were invented in 2003 by Hon Lik—a pharmacist who was seeking to quit smoking after his father, who also smoked, was diagnosed with lung cancer. Legacy tobacco companies did not enter the vapor market until years later, long after people who smoke had been taking matters into their own hands, building and improving vaping devices, and spreading the word in an inspired grassroots effort. To equate tobacco harm reduction with Big Tobacco is no more valid than equating opioid harm reduction with the Pharma companies that make opioids and medications for opioid use disorder.
The goal should not be a moralistic crusade to make people do what the WHO wants. The goal should be fewer funerals of the kind I’ve attended far too often.
Unfortunately, the perversion of harm reduction messaging and the truth is a pattern the WHO has repeated, growing more brazen over the years.
World Cancer Day is not the time to hide the truth behind a mask of moral outrage. It’s time to communicate risk precisely. That means naming the core cancer hazard clearly: smoking. It means being clear that nicotine is associated with dependency, but not with cancer. And it means recognizing and learning from the lived experience of people whose health and lives have been transformed by switching to safer nicotine.
The goal should not be a moralistic crusade to make people do what the WHO wants. The goal should be fewer funerals of the kind I’ve attended far too often.
Photograph (adapted) by Klaus Nielsen via Pexels