WHO Urged to Embrace Nicotine Alternatives

The World Health Organization should embrace safer alternatives to cigarettes in order to save 100 million lives that will otherwise be lost to smoking, according to Derek Yach, a global health consultant who led the WHO’s Tobacco Free Initiative during development of the Framework Convention on Tobacco Control was previously president and founder of the Foundation for a Smoke-Free World.

“The WHO’s Framework Convention on Tobacco Control (FCTC) has not kept pace with scientific and technological advancements,” Yach writes in The Lancet. “Over 120 million people worldwide, in seeking a path away from combustible cigarettes, have turned to safer alternatives, such as e-cigarettes, oral nicotine pouches and heated tobacco products. Evidence suggests that these alternatives improve quit attempts compared to traditional nicotine-replacement therapy.

“Yet, the FCTC’s current emphasis on bans, prohibitions and regulations undermines access to these safer alternatives for millions of tobacco users. It is time to recognize their potential and prioritize harm reduction.”

Writing in response to The 20th anniversary of the WHO Framework Convention on Tobacco Control: hard won progress amid evolving challenges, Yach sets out a three-point plan that he says could result in potentially 100 million fewer premature deaths between 2025 and 2060:

• Incorporate tobacco harm reduction: The FCTC should actively promote safer alternatives, recognizing their role in reducing harm.
• Balanced Regulation: While regulation is necessary, it should not stifle innovation or limit access to safer products.
• Science-based policies: Governments must base decisions on evidence, fostering independence and informed choices.

“We cannot afford to wait for a miracle,” he says. “The WHO must adapt swiftly to the changing landscape of tobacco use and embrace innovative strategies to protect public health.”

Yach disputes Kelly Lee and colleagues’ contention that tobacco companies’ development of safer alternative is purely profit-driven.

“Negotiations leading to the FCTC’s adoption were intricate and delicate, resulting in nearly all major tobacco producers (except the USA and Indonesia) becoming signatories,” Yach says. “Rather than demonizing these legacy companies, we should acknowledge their evolving stance. Many are actively shifting away from combustible cigarettes, embracing safer alternatives as technology evolves.

“Saving lives requires bold action. Let us unite in our commitment to a smoke-free future—one where harm reduction leads the way.”