Category: Harm Reduction

Cullip: China Could Revolutionize THR

Martin Cullip (Photo: Tobacco Reporter archive)
China has the potential to revolutionize global tobacco harm reduction now that its government has asserted authority over e-cigarettes, according to consumer advocate Martin Cullip.
On Nov. 26, China’s State Council on Nov. 26 amended the country’s tobacco monopoly law to include vapor products, which means that vaping products and their manufacturers will be regulated by the Chinese government under the same process as cigarettes.
The announcement triggered feverish speculation about the impact of the new rules, with some commentators fretting that tobacco rules would put vapor companies out of business and others welcoming the prospect of enhanced product safety and quality.
Writing in Filter, Cullip points not only to the vapor industry’s economic significance to China, but also to the potential domestic health benefits of sensible regulation. China, argues Cullip, has a lot to gain from financially from domestic harm reduction, when the country’s high smoking prevalence in an aging population creates heavy costs in health care and lost productivity.
Cullip is also encouraged by China’s willingness and ability to stand up the World Health Organization, which remains ideologically opposed to tobacco harm reduction.
While the government would seem to have much to gain from blocking the growth of safer alternatives such as e-cigarettes and tobacco-heating products—the state-owned CNTC sells more than 40 percent of the world’s cigarettes—there are many incentives for the government to push things in an entirely different direction, according to Cullip.
China manufactures the vast majority of the world’s vape products. More than 170,000 businesses engage in e-cigarette production and the supply chain, employing around 3 million people. The CNTC is also the world’s biggest holder of tobacco harm reduction patents, owning almost 27 percent of all related patent publications.
“It is difficult to imagine the government strangling the market—even if this is motivated more by profit than by its citizens’ health,” writes Cullip.
December 8, 2021
Fighting the Last War
A new report by Knowledge-Action-Change urges the World Health Organization to embrace safer nicotine products.
By George Gay
On the face of it, it seems odd that a case has to be made for the promotion of safer nicotine products (SNPs) as part of a global tobacco harm reduction (THR) strategy. But making this case, in large part, is the aim of a report published by the U.K.-based public health agency Knowledge-Action-Change (KAC) and launched at a hybrid event on Oct. 27 in London. And it has to be said that the case needs to be made, as becomes clear toward the end of the report, in a section looking toward the future, where it is stated that it is a “moral imperative” that the World Health Organization and its allies retrench from their current “intransigent and obstructive position of not only refusing to accept any positive health benefits from SNPs but actively campaigning against their use.”
I would agree wholeheartedly with the general sentiment being expressed here, but invoking morality is problematic, I believe. The idea of an overarching morality is not universally accepted because a lot of people believe “morality” resides in the preferences individuals or groups of people have. And, in fact, Harry Shapiro, the author of the report Fighting the Last War: The WHO and International Tobacco Control, seemed to acknowledge this point when, speaking at the launch, he said everybody working in tobacco control was aiming to reduce smoking but that tobacco control split into two broad camps: one comprising those who supported SNPs and THR and the other comprising those who didn’t. This was a good concession to make because having the word “war” in the title of the report seemed to be pointing us back down a road we surely don’t want to travel.
Misguided and Irrational
Having said that, this is a good report aimed at challenging the direction of travel of tobacco control under the auspices of the WHO’s Framework Convention on Tobacco Control (FCTC) ahead of the Conference of the Parties to the FCTC, COP9, which was due to take place virtually on Nov. 8–13 (after this report was written). In doing so, the report seeks to address what must surely be one of the most unsound and unreasoned strategies ever to have arisen within the international health community. Put briefly, it is about the WHO and its allies being not immoral but, more worryingly, misguided and irrational.
According to the WHO, an epidemic of cigarette smoking is currently causing the deaths of 8 million people a year, usually referred to as “premature deaths,” a phrase up there with “pre-ordering” in the list of linguistic curiosities. But while a number of SNP products have been developed that can wean people off tobacco smoking, the most powerful international body charged with protecting the health of people around the world has decided it would be best not to use these products but to apply the old “quit-or-die” patch to the gaping wound. After all, quit-or-die has a long track record whereas the products being offered up are—mention it only in hushed tones—new or newish. The fact that the long track record of quit-or-die is, like the art of bleeding patients, one largely comprising failure seems not to enter the thinking of the WHO and its allies.
But perhaps this isn’t fair. The report makes the point that the number of smokers worldwide has remained at 1.1 billion for the past 20 years, during which time, I understand, the world’s population rose from 6.11 billion to 7.75 billion, so it could be argued that the number of smokers would, without intervention and with all other things having remained equal, have risen to 1.38 billion. So what has occurred might not be failure, I guess, but it is hardly a galloping success.
Of course, it might be said correctly that individuals and states are not bound to follow the WHO’s advice, but it is often the case that they do, perhaps because of the peculiar tendency of humans to create or invent institutions or belief systems and then slavishly accept the advice purportedly coming out of them, no matter how daft, rather than go back and question whether there was a fault in the original idea that gave rise to the institution or belief system.
But I would not recommend going back to question the setting up of the WHO itself, which, to my mind, should be a powerful force in the global fight against transmissible diseases, but to question the WHO’s FCTC, whose provisions are used to steer the direction of travel of the international tobacco control movement.
A Matter of Interpretation
Harry Shapiro
The report does an excellent job of explaining the roles of the WHO, the FCTC, the Conference of the Parties to the FCTC and the FCTC secretariat, the relationship between them and the decision-making processes they employ. This section of the report doesn’t make encouraging reading, however, though it largely defends the FCTC’s provisions and blames the way they are interpreted for the failure to embrace SNPs and THR. It is said that the provisions of the FCTC are no bar to the consideration of scientific advances, new technologies, economic circumstances and the concept of THR. But this is surely no reason to keep heading down the same road hoping things are miraculously going to get better, especially given that the seemingly unaccountable FCTC secretariat is making much of the running, and nation states tend to go with the flow, unlike when they discuss other global issues such as trade. There have been eight FCTC-based COP meetings since the COP first met in 2006, and I cannot help thinking that, given the lack of progress it has made in 15 years of working with the FCTC, the decent thing to do would be to put the COP and the FCTC out of their misery.
One of the problems identified in respect of COP meetings is that they are almost totally exclusive, owing to a particular interpretation of an FCTC provision. And a comparison is made in the report, and was repeated by others at the report launch, of the FCTC COP meetings and those associated with the Framework Convention on Climate Change (FCCC). The tobacco COPs were said to be shrouded in a level of secrecy comparable to U.N. Security Council meetings whereas to be an observer at the FCCC COP, it was necessary only to demonstrate representation of a national or international body and relevant experience. The inference was that if more people were allowed to observe and even take part in the tobacco COP, things would be better.
I hate to spoil the party here, but the comparison is a little out of proportion, to my way of thinking. Tobacco COPs look at consumer choices involving various tobacco and nicotine products whereas the FCCC COPs are about trying to prevent the whole of humankind going belly up. The comparison seems also to gloss over the evidence. As I write this, the FCCC COP, COP26, is about to start and is widely expected to end largely in a PR-burnished failure, with the result that the world will be plunged deeper into the existential crisis it is already in and from which it is unlikely to be able to row back. Having more participants doesn’t seem to guarantee success, at least not on its own, even where the fate of the earth hangs in the balance.

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The Way Forward
So, how could things be arranged to ensure a more beneficial outcome to the problem of tobacco smoking? Well, through the employment of THR, where harm reduction is defined in the report as “a range of pragmatic policies, regulations and actions that either reduce health risks by providing safer forms of products or substances or encourage less risky behaviors with an important role in championing social justice and human rights for people who are often among the most marginalized in society.” One of the most frustrating aspects of the refusal of the WHO and parties to the FCTC to embrace THR is that the WHO employs harm reduction in respect of other health issues. Such an inconsistent stance is difficult to understand, but then perhaps there is a visceral satisfaction in bleeding the patient, either actually or metaphorically, through taxation, the main weapon in the quit-or-die armory. Increasing tobacco taxation is held up as a quit-or-die success story, but, in fact, it is a strategy that further impoverishes the often less well-off while providing a boost for black marketers.
Under a section titled “What can be done? New thinking for the 21st century,” it is said that parties to the FCTC should press for more evidence-based discussions on THR and SNP. This is a nice thought, but given the history laid out in the report, I wonder if it can lead anywhere helpful. I’m sure COP participants believe they are making evidence-based decisions already, but my guess is, to get back to my original point, they are viewing only the evidence that is able to squeeze through their locked-in “moral” filters. The more alcohol they quaff together, the more they come together in the belief that nicotine is evil and shouldn’t be enjoyed. Evidence is no guarantor of success. The EU’s deadly ban on snus, a ban that defies all reason, has been upheld in the courts.
Under the same section, it is said also that a pragmatic route forward could be the establishment of a working group on THR to take the FCTC forward into the 21st century in a world where SNPs are now available. This, too, is a good thought, but again, given the history laid out in the report, one that might be difficult to pull off. Still, nothing ventured, nothing gained, and the report describes five ways in which such a working group might be able to move things forward.
One of the key starting points is said to be disaggregating combustible and more dangerous oral tobacco products from safer noncombustible products. But is this likely when, in a world where we hang onto the belief that the U.S. Food and Drug Administration is the paragon of scientific reason, that agency feels it right, and has the right, to “deem” electronic cigarettes to be tobacco products?
It is easy to become gloomy about the situation, especially when it is considered that even if a smoker is saved from a tobacco-related death through switching to an SNP, she is anyway more likely now to die of a pollution-related disease (for which there is no COP), or, slightly further into the future, the effects of a climate change event.
But, looking on the bright side, there is a powerful and growing force in support of THR, and it was on display at an event in London on the day following the launch of the Fighting the Last War report. The THR scholarship program, which is described as the jewel in the crown of the KAC, was the subject of a separate report, Tobacco Harm Reduction Scholarship Program: The First Three Years 2018–2021, which describes how the program has built an extensive network of advocates raising awareness of THR around the world.
The report is worth reading. Although I was aware of the program, I had no idea how extensive it had become. Since its launch, the program has attracted 260 applications and has taken on 75 scholars from 33 countries, 18 of whom have gone on to enhanced scholarships. But perhaps the most significant figures are those describing how 95 percent of the scholars are still working in THR, 27 percent full-time, 50 percent part-time and 18 percent on a voluntary basis.
The Oct. 28 event was an opportunity also to celebrate the life of Kevin Molloy (1957–2021), who, from 2018 until earlier this year, was head of the scholarship program.
The Fighting the Last War report, which is part of a series of Global State of Tobacco Harm Reduction reports from KAC, and the scholarship program are funded by grants from the Foundation for a Smoke-Free World, a U.S. nonprofit organization that had no role in the planning or execution of either project.
George Gay is Tobacco Reporter’s European editor, but his territory spans the globe. Based in London, George has covered the tobacco industry since 1982, initially for a U.K.-based publication and since 2004 for Tobacco Reporter. George’s understanding of industry issues, combined with his keen sense of observation and dry wit, have earned him a loyal following among Tobacco Reporter’s readers.

December 1, 2021
SCOPE Launches THR Online Library

SCOPE has launched a comprehensive library of online panel discussions and presentations relating to tobacco harm reduction (THR).
A global collaboration of THR consumer groups, SCOPE includes Consumer Advocates for Smoke-Free Alternatives Association (CASAA) in the United States, Iberoamerica (ARDT) in Latin America and the Coalition of Asia Pacific Tobacco Harm Reduction Advocates (CAPHRA).
SCOPE recently broadcast around the clock during the nineth Conference of Parties for the World Health Organization’s Framework Convention on Tobacco Control (FCTC).
Alex Clark
“SCOPE’s five-day global livestream was a huge success, countering and shining much-needed sunlight on COP9. It shows just what can be achieved when international consumer organizations come together in their tireless work to humanize and promote the life-changing tobacco harm reduction movement,” says Alex Clark, CEO of CASAA.
Hours of SCOPE’s presentations by international THR experts and panel discussions featuring consumer advocates have now been uploaded into one online library, available at https://bit.ly/319zzkx
Nancy Loucas, executive coordinator of CAPHRA, says if more smokers’ lives are to be saved then the World Health Organization must not be allowed to continue to demonize safer nicotine alternatives like vaping. Instead, it must be mandated to follow the scientific evidence.
It’s critical, she says, over the next two years that the world’s THR organizations work more closely and effectively together.
“SCOPE provides consumers, the public and the media with an invaluable resource and platform going forward. Our focus now shifts to COP10 in 2023 where risk reduced products will be a key discussion topic for delegates. With over one billion smokers’ lives at stake, consumers need one clear voice and SCOPE now provides that,” says Loucas.
Ignacio Leiva Benitez
Chilean consumer advocate Ignacio Leiva Benitez, general secretary of ARDT Iberoamerica, says Latin America is delighted to be part of SCOPE. His organization, he says, is now working more closely with allies from all around the world.
“SCOPE is all about showing the world’s decisionmakers what has worked for us individuals and changed our lives for the better,” says Benitez. “I started vaping 12 years ago, after smoking two packets of cigarettes a day. For years I tried different ways to quit but was unsuccessful until I discovered nicotine vaping. SCOPE will enable us to fight more successfully on behalf of adult smokers, in every country, to gain better access to safer alternatives.”
November 29, 2021
Call for THR Scholarship Applications
Photo: zimmytws
Knowledge Action Change (KAC) is looking for people to propose projects exploring their professional or personal interest in tobacco harm reduction (THR) for the next cohort of its Tobacco Harm Reduction Scholarship program (THRSP). Applications for the fifth year of the program close on Nov. 30, 2021, and successful applicants will receive a 12-month bespoke mentoring program and up to $10,000 in financial support.
According to Paddy Costall, a director at KAC, the THRSP is a crucial part of global efforts to communicate the benefits of safer nicotine products, helping to raise awareness about vaping, heated tobacco products, snus and nicotine pouches.
“The Tobacco Harm Reduction Scholarship program is the jewel in the crown for KAC,” he says. “When we were setting out on this journey, we wanted to attract a passionate and diverse group of new advocates into the tobacco harm reduction field from across the globe. We wanted to inspire them to take the movement into the future. We wanted to find the researchers of tomorrow, and with the THRSP that is exactly what we are doing.”
To further enhance the program’s status, KAC recently appointed Ethan Nadelmann, the founder of the Drug Policy Alliance, as the THRSP’s new patron. Nadelmann will be providing support to the recipients of these scholarships.
Launched in 2018, the program has supported 75 Scholars on six continents. Projects completed by THRSP participants include:
A short documentary film exploring attitudes on smoking and THR in Malawi
Novel scientific research in Romania showing that switching completely from combustible cigarettes to heated tobacco products can boost the oral health of smokers
The creation of a smoking and recovery toolkit in the U.S. to combat the high rates of smoking among people in recovery or seeking treatment for dependency on alcohol or other drugs
A study assessing the THR knowledge base of healthcare staff in Lithuania
A pair of studies that demonstrated the potential for safer nicotine products, such as vaping and Swedish-style snus, to help India’s smokers and smokeless tobacco users
The creation of THR Uganda, an organization set up to share accurate information on tobacco smoking and nicotine with its own dedicated website
A study on the effects of providing vapes to homeless smokers in Ireland
To find out more about the program, visit the Tobacco Harm Reduction Scholarship program website.
November 23, 2021
Late to the Game: Harm Reduction in the Middle East

Photo: Fertas
The Middle East lags behind other regions in limiting the risk of tobacco consumption.
By Stefanie Rossel
At the end of August, Chinese vape brand RELX officially launched in Saudi Arabia. After the United Arab Emirates (UAE) and Kuwait, the kingdom became the third country in the Gulf region where RELX International’s products are now available. The move also signaled the manufacturer’s intention to expand into the rest of the Middle East and North Africa (MENA) this year. “The MENA region is one of our category’s fastest growing markets, growing at a rate just short of 10 percent until 2024,” Fouad Barakat, general manager at RELX International for the Kingdom of Saudi Arabia, commented on the launch. “Saudi Arabia is one of the region’s largest and most prosperous markets, hence the need for any brand to launch there if it wants to thrive and grow bigger.”
One of the reasons for expansion was the kingdom’s announcement of new regulations, similar to those set across Europe, following the standard setup for e-cigarette and heated-tobacco product (HTP) packaging and labeling, which was introduced in September 2020. With these plans, the country would be a forerunner in the region—few Middle Eastern countries have no regulation for cigarette alternatives in place. In fact, prohibition is the most common attitude in the Middle East when it comes to tobacco harm reduction (THR).
Often, the legal status of reduced-risk products (RRPs) is unclear: According to a list published by Vaping360 in October, vapor products are legal to use but illegal to sell in Egypt, which is alleged to be on the verge of regulating vaping production, Lebanon and Turkey, where the import of e-cigarettes is also banned. In Iran, Kuwait and Oman, e-cigarettes are merely believed to be legal to use but illegal to sell. Marija Obradovic, head legal analyst at ECigIntelligence, claims that vape products have remained forbidden in Oman since 2015 and in Qatar since 2012, whereas Bahrain and Kuwait legalized them in 2016 followed by Jordan and the UAE in 2019. Vaping products are legal in Israel but banned in Syria.
Similar disparities prevail with other RRPs. According to the Global State of Tobacco Harm Reduction (GSTHR), snus is allowed in Egypt, Kuwait, Lebanon, Oman, Qatar, Saudi Arabia, Syria and the UAE whereas HTPs are legal only in Israel, Syria and Turkey but are not marketed in Syria and Turkey. Instead, they are on sale in Bahrain, Kuwait, Oman, Qatar, Saudi Arabia and the UAE where laws for these products don’t exist yet.
Against this background, it is unsurprising that the adoption of alternatives to conventional cigarettes in the Middle East has lagged behind other regions. According to Euromonitor International, a mere 1.8 percent of smokers in the region had switched to RRPs in 2020, up from 1.4 percent in 2017. Adoption was even lower than in Asia-Pacific nations (4 percent) and Latin America (2.3 percent).
Smoking rates in the Middle East, however, remain among the highest globally. Jordan, for example, now has the world’s largest share of smokers in its population. With 66 percent of Jordanian men and more than 17 percent of women smoking, the country seems to even have surpassed Indonesia, a government study carried out in 2019 in collaboration with the World Health Organization found.

“At one level, it is up to manufacturers to produce affordable products, but there has to be a regulatory system including taxation levels that allows for the R&D finances to be recouped and for markets to be allowed to grow.”
Harry Shapiro, author of the GSTHR reports
Monopolies and Taxation
One reason for the failure of RRPs to make significant inroads is the fact that many Middle Eastern governments have financial stakes in their tobacco markets through state monopolies or shareholdings in tobacco companies. “There are four countries in the Middle East where the state owns 100 percent, one where the state owns over 50 percent and one over 30 percent of at least one tobacco company,” says Harry Shapiro, author of the GSTHR reports. “In Egypt, the state owns 51 percent, in Lebanon, Iran, Iraq and Syria, 100 percent, and in Yemen, 34 percent. Within those countries, Lebanon adult smoking prevalence is very high at 42 percent. Others are much less, but clearly where you have a state-owned industry, the state is not going to welcome the importation of alternative products, which will threaten revenues even where there is a proven health benefit. It all comes down to money in the end. Politically, business and finance interests will always trump health.”
Of the world’s approximately 1.1 billion smokers, around 80 percent live in low-income and middle-income countries. Affordability of RRPs, or rather the lack of it, plays an important role, and this is also true for the Middle East, Shapiro adds. “This is a big issue, especially where you have a growing market in illegal cigarettes and no doubt centuries-old traditions in locally produced combustible tobacco products, which support the incomes of poorer people. At one level, it is up to manufacturers to produce affordable products, but there has to be a regulatory system including taxation levels that allows for the R&D finances to be recouped and for markets to be allowed to grow. The other problem for affordable products in an anti-THR climate is repetition of the tedious narrative that THR is all about boosting profits for Big Tobacco in a declining cigarette market.”
Vapor products are unlikely to become more affordable in the Middle East soon. “Countries are quick to introduce specific taxes on e-cigarettes even before regulating the product itself,” observed Obradovic as she compared regulatory pathways in Eurasia and the Middle East in a webinar in April. Kuwait taxes e-liquids with or without nicotine at 100 percent of the sales price; Saudi Arabia and the UAE have introduced a 100 percent excise on liquids with or without nicotine and on devices. With a 200 percent tax on both nicotine-containing and non-nicotine-containing liquids as well as devices, Jordan has taken taxation of RRPs to the extreme. “Although e-cigarettes are nominally allowed, this makes it completely unfeasible to operate,” Obradovic said.
Like the makers of RELX vape products, Shapiro nevertheless remains optimistic about the future adoption of reduced-risk products in the Middle East. “My understanding is that the market for safer nicotine products is growing as it is in many parts of the world. My guess would be that the market would grow fastest among the more well-off in society and among younger smokers who should be encouraged to switch. All the evidence shows that if you can switch away from smoking by the age of 35, you can reverse much of the damage caused by previous years of smoking.”
Stefanie Rossel is Tobacco Reporter’s editorial contributor. An experienced trade journalist, she combines sharp reporting skills with in-depth knowledge of the tobacco and vapor industries. Prior to joining Tobacco Reporter, Stefanie was editor-in-chief at Tobacco Journal International, where she worked for a decade. Fluent in English, German and French, Stefanie covers tobacco news around the world. She is based in Germany.

November 22, 2021
Consumer Confusion Preventing Cessation

Photo: kues1
Confusion about smokefree alternatives is preventing many smokers from quitting smoking according to a global survey, reports Arab News.
Commissioned by Philip Morris International and conducted by Povaddo, the study surveyed nearly 30,000 people in 26 countries. The researchers found that many adult smokers remain unaware that alternatives to cigarettes exist, are unable to access them, or are confused by conflicting information that prevents them from making an informed choice.
The survey showed that despite the science backing up smokefree alternatives, there was public confusion surrounding these products, such as heated tobacco products or e-cigarettes.
Thirty-three percent of the respondents cited a lack of information about how these products differ from cigarettes and 35 percent said they were unsure about the science behind these new products.
The survey found that 32 percent of smokers have easier access to cigarettes and so don’t switch to alternatives.
“The findings of the survey show there is confusion about smokefree products. For those adults who would otherwise continue to smoke cigarettes, having access to evidence-based information about smoke-free products is critical,” said Tarkan Demirbas, area vice-president for the Middle East at PMI.
According to the World Health Organization, there are more than 1 billion smokers in the world today, and this number is expected to stay steady until 2025.
November 22, 2021
‘Good COP, Bad COP’ Awards Announced
Tobacco harm reduction (THR) advocates have handed out “Good COP, Bad COP” awards following the ninth Conference of the Parties (COP9) to the World Health Organization Framework Convention on Tobacco Control (FCTC) from Nov. 8-12.
Banned from participating in the gathering the THR advocates organized a global livestream that ran simultaneously to the COP9.
Dubbed sCOPe, the round-the-clock YouTube simulcast attracted significant attention, adding to increasing international pressure on the WHO to embrace safer nicotine products, not demonize them.
Nancy Loucas of the Coalition of Asia Pacific Tobacco Harm Reduction Advocates says sCOPe gave a voice to leading consumer advocates who were shut out of COP9. The focus, however, must now move to preparing for COP10 in 2023 where harm reduction products will be a key discussion for delegates.
“Those of us passionate about safer nicotine products must reach out to the likes of public health officials and influencers. We need to humanize this debate and show how vaping has saved the lives of millions of ex-smokers,” said Loucas.
sCOPe’s Good COP awards:
The “Wow, Someone’s Actually Telling Us What’s Going On” Award went to COPWATCH for getting on the inside and giving the world real-time insights online.
The “Give the Man a Cigar” Award went to Philippine Foreign Affairs Secretary, Teodoro Locsin Jr, for standing up to COP9 delegates by promoting the use of science in tobacco control.
The “I am the Evidence” Award went to passionate U.S. consumer advocate and sCOPe panellist, Liana Hudspeth.
sCOPe’s Bad COP awards:
The “You Shouldn’t Really Say That About Yourself” Award goes to FCTC Head Adriana Blanco Marquizo for her “How industry weaponizes science” Tweet, which the THR advocates described as “very bizarre.”
The “Our Proposal Won’t Do A Thing But Delegates Loved It” Award went to Iran, whose government holds a sizable stake in its domestic tobacco industry.
The “Where the Hell Is Wally” Award went to WHO sponsor, anti-vape crusader, and American billionaire Michael Bloomberg for trading in COP9 and instead flying to the COP26 Climate Conference in Glasgow.
November 21, 2021
Filipino Delegate Lauded for ‘COP Courage’

Teodoro Locsin Jr.
(Photo: Philippine Department of Foreign Affairs)
Tobacco harm reduction (THR) advocates and vapers have praised Philippine Foreign Affairs Secretary Teodoro Locsin Jr. for his insistence at the ninth Conference of the Parties (COP9) that the latest scientific information must be considered to solve the global smoking problem.
“We salute his bravery at COP9 for promoting the Philippines’ balanced and evidence-based approach to safer nicotine products,” said Peter Dator, president of consumer group Vapers PH and Coalition of Asia Pacific Tobacco Harm Reduction Advocates (CAPHRA) member. “Opponents and officials have since done their best to discredit Secretary Locsin and disrespect our country’s democracy and sovereignty, but they have failed badly.”
“In a world where smoking causes 8 million deaths every year, Secretary Locsin has done everyone a huge favor,” said Nancy Loucas, executive coordinator of CAPHRA. “Telling COP9 about the success of ‘far less harmful novel tobacco products’ and the Philippine government’s political support for them was music to the ears of the millions who’ve successful[ly] quit deadly cigarettes via vaping.”

We salute his bravery at COP9 for promoting the Philippines’ balanced and evidence-based approach to safer nicotine products.
Peter Dator, president, Vapers PH
Loucas organized a global livestream called sCOPe during COP9, featuring leading THR experts and consumer advocates. The livestream added to the increasing pressure on the WHO to embrace safer nicotine products.
“How can we trust the WHO and the FCTC when they are afraid of science? In this age of fake news and alternative facts, it is important for governments to take a stand for the facts and know how to sift through the propaganda. This is what Secretary Locsin did at COP9, and I join the Philippine Cabinet and Congress in commending his actions,” said Dator.
Earlier, Locsin had drawn fire from the Philippines Department of Health for stating that tobacco products were a “source of good through taxation” for the Philippines.
The health department said that it was misleading to praise the tobacco industry’s role in raising tax revenues. In 2011, the cost of tobacco-related diseases was estimated at PHP177 billion ($3.54 billion) annually, the agency noted. This was seven times higher than the PHP25.9 billion collected in taxes from tobacco products.
November 16, 2021
New Report Questions WHO’s Vaping Stance
A new report, published today, raises major questions about the anti-vaping arguments and approach of the World Health Organization and billionaire philanthropist Michael Bloomberg.
The WHO and Bloomberg have both made clear their opposition to safer nicotine alternatives despite growing evidence of lower harm and efficacy for smoking cessation.
The WHO’s tobacco control program is funded in part by Bloomberg Philanthropies. In July of this year, the two parties restated their joint position at the launch of the WHO Report on the Global Tobacco Epidemic, 2021: Addressing New and Emerging Products. In this report, the WHO emphasized that electronic nicotine-delivery systems are “a threat to tobacco control,” are harmful and should be banned or highly regulated. Bloomberg, in his capacity as the WHO Global Ambassador for Noncommunicable Diseases and Injuries and founder of Bloomberg Philanthropies, stated that tobacco companies are marketing new products such as e-cigarettes to “hook another generation on nicotine.”
The International Network of Nicotine Consumer Organizations (INNCO) has now compiled a new dossier, titled Bloomberg, WHO and the Vaping Misinfodemic, containing statements and evidence from healthcare experts, leading academics, politicians, respected journalists and research organizations that question the stance of the WHO and Bloomberg on safer nicotine alternatives to smoking and the relationship between the two parties.
This dossier comes just a week after the U.K. Department of Health and Social Care announced that e-cigarettes could be prescribed on the National Health Service, a world first. That move by the U.K. government provoked significant public debate around the polar opposite views toward safer nicotine alternatives, such as vaping, held by the British government and the WHO.
The dossier also comes as the Parties to the WHO Framework Convention on Tobacco Control convene to discuss tobacco and nicotine policy.
The outcomes from COP9 discussions will determine how international tobacco control policies are implemented at a country level across the globe to address the fact that 1.1 billion people still smoke worldwide and 8 million die every year from tobacco-related diseases.
The dossier highlights nine reasons why serious questions need to be raised about the WHO’s and Bloomberg’s outright opposition to safer nicotine alternatives to deadly smoking. High on the list is their failure to distinguish between smoking addiction and nicotine dependence.

They are shifting the harm focus from smoking to tobacco to nicotine—where it obviously doesn’t belong.
Charles A. Gardner, executive director, INNCO
“Effectively, through this failure, they are shifting the harm focus from smoking to tobacco to nicotine—where it obviously doesn’t belong—nicotine does not cause cancer, heart or lung disease. Smoking does,” says Charles A. Gardner, executive director at INNCO.
This is backed up in the dossier by expert views on the profound difference between cigarette smoke and the drug, nicotine, including those expressed by Jamie Hartmann-Boyce, senior research fellow in health behaviors at the University of Oxford; John Britton, emeritus professor of epidemiology at the University of Nottingham and special advisor to the Royal College of Physicians on Tobacco; Adam Afriye MP; and a joint statement by 15 past presidents of the world’s top professional society in the field of tobacco control, the Society for Research on Nicotine and Tobacco.
The report also scrutinizes the WHO’s role in COP events, with evidence suggesting that it is very controlling in terms of the agenda and attendance. Unlike COP26, these tobacco control COP meetings are described as “all but excluding the media,” “well-known for the routine ejection of the public from proceedings” and “notoriously secretive.”
The dossier also reports on claims that the only tobacco control nongovernmental organizations (NGOs) allowed to attend are those who subscribe to the WHO’s tobacco harm reduction denialist stance. The U.K. Parliament’s All-Party Parliamentary Group for Vaping recently issued a warning about the participation at COP9 of The Union, a major global NGO funded by Bloomberg Philanthropies.
“The Union [International Union Against Tuberculosis and Lung Disease] recently issued a major report titled Where Bans are Best: Why Low- and Middle-Income Countries Must Prohibit E-cigarette and HTP Sales to Truly Tackle Tobacco. The Union is one of Bloomberg Philanthropies’ two top tobacco control grantees—the other is the U.S.-based Campaign for Tobacco-Free Kids,” says Gardner.
“We are a good case in point. INNCO, which represents and supports the rights of 98 million adults worldwide who use safer nicotine to avoid toxic forms of tobacco, has once again been denied observer status at COP9 (as it was denied at COP8 and at COP7).”
The Bloomberg, WHO and the Vaping Misinfodemic report calls for:
Governments around the world to collectively challenge the WHO’s and Bloomberg’s current prohibitionist position on safer nicotine alternatives and to demand to know why, in the face of 8 million tobacco-related deaths every year, the tobacco control field is the only field of public health that rejects harm reduction
The formation of a global independent Tobacco Harm Reduction Working Group comprised of independent scientists, global health experts, specialist academics and people who use safer nicotine (ex-smokers)
Withdrawal of funding from and/or boycott of future Conference Of Parties (COP) tobacco control meetings until the WHO considers the overwhelming evidence that safer nicotine alternatives such as vapes, snus, nicotine pouches and heat-not-burn help smokers quit and save lives
Complete transparency in all tobacco control funding, grants and collaborations involving the WHO and Bloomberg
A full independent and international review into current and past tobacco control dialogue between Bloomberg Philanthropies, Bloomberg-funded NGOs and national governments in low-income and middle-income countries (LMICs) following allegations in the Philippines that the country’s Food and Drug Administration received funds from Bloomberg groups to support the implementation of the national tobacco control program
A complete review of the WHO’s public web-based Q&A on e-cigarettes, which has been described as “astonishingly bad.”
The dossier also spotlights the EVALI (e-cigarette, or vaping, product-associated lung injuries) crisis of 2019. The U.S.-only outbreak of lung injuries caused by bootleg THC (cannabinoid) vape oils “cut” with one or more adulterants was wrongly reported to be caused by legal nicotine vaping.
According to the report, the EVALI outbreak triggered Bloomberg Philanthropies to invest $160 million over a three-year period to prohibit all e-cigarette flavors other than tobacco flavor. EVALI is also still incorrectly referenced by the WHO in its Q&A on vaping products in response to the question as to whether e-cigarettes cause lung injuries.
However, by early 2020, U.S. authorities identified vitamin E acetate, a cutting agent used in some bootleg THC vaping oils—mainly in U.S. states where cannabis remains illegal—as the primary cause of the outbreak.
As reported in the dossier and which escaped the attention of the world’s media, last month, 75 global experts with no tobacco industry ties, including seven individuals who have served as president of the Society for Research on Nicotine and Tobacco, wrote to the CDC’s director asking her to change the name “EVALI” because it fails to alert THC vapers to their potential risks and it misleads smokers and nicotine vapers to believe e-cigarettes were the cause.
“I’ve spent 30 years in global health, including three years as a senior advisor on research to the WHO. For most of my career, I worked on HIV, TB, malaria, dengue, rabies, nutrition and child health issues. So, I’ve never seen anything as crazy as what’s happening now in tobacco control. What troubles me is how few people outside of my ‘little’ echo chamber, the community of millions of ex-smokers who use safer nicotine, knows what’s going on,” says Gardner.
“There are 1.1 billion smokers now in the world, a situation that has barely changed in the last 20 years. The anti-harm reduction conservatism of the WHO and Bloomberg is not working.
“That’s why we are calling for a global response in the form of a tobacco harm reduction working group and international governments collectively questioning and challenging the WHO[‘s] and Bloomberg’s prohibitionist and evidence-denialist approach to safer nicotine. Because we are ex-smokers who use safer nicotine. We see what’s happening, and we have great empathy for smokers and ex-smokers who vape.
“The goal is simple. Save lives. Only the starting assumptions and strategies to get there differ. These can be debated. But this debate is unethical if it does not include people who have, themselves, made the transition from smoking to not smoking, using tobacco harm reduction products (nicotine patches, nicotine gum and lozenges, nicotine vapes, nicotine pouches, snus and HTPs).”
“Our future policy recommendations will focus on the need to change research priorities, just as HIV/AIDS activists sought to do in the 1990s. Global tobacco control research priorities today are skewed toward finding harms of alternative nicotine products while ignoring—or not even exploring—benefits, in particular the potential therapeutic benefits of nicotine. The health benefits of medical marijuana are now recognized because of research. The potential therapeutic benefits of psilocybin are now being explored (e.g., for PTST and even for smoking cessation). However, research to explore those potential benefits was locked in amber for 30 years because of prohibitionist drug laws.”
November 9, 2021
More Calls for THR Ahead of COP9

Photo: andriano_cz
Activists continue to urge participants in the ninth Conference of the Parties (COP9) to the World Health Organization’s Framework Convention on Tobacco Control to seriously consider tobacco harm reduction in their deliberations.
COP9 will take place Nov. 8-13 online. During the convention, delegates will debate measures to reduce smoking-related death and disease. To the frustration of many tobacco harm reduction proponents, the WHO has been suspicious of vaping and other reduced-risk products, viewing them as an industry tool to keep consumers hooked on nicotine.
“Tobacco harm reduction is a chance for smokers to switch from an extremely harmful to a significantly less harmful alternative,” the Independent European Vape Alliance (IEVA) wrote in a statement ahead of the gathering.

We would like the WHO, together with other representatives from politics and science, to develop a targeted strategy for reducing the damage caused by smoking.
Dustin Dahlmann, president, IEVA
“Unfortunately, the WHO has lost sight of this in recent years. But it is not too late to repent. It must focus on the future of millions of smokers worldwide—a future that is much brighter should they switch to vaping—rather than its own counterproductive ‘quit-or-die’ dogma.”
“As a European association that is independent of the tobacco industry, we would like the WHO, together with other representatives from politics and science, to develop a targeted strategy for reducing the damage caused by smoking. Of course we as an industry are ready for this critical dialogue,” said Dustin Dahlmann, president of IEVA.
“The World Health Organization’s failure to declare a global emergency in 2020 [in the wake of the coronavirus pandemic] will be repeated in 2021 when the WHO will likely abandon international tobacco harm reduction efforts and condemn millions of smokers to an early death,” said Nancy Loucas, a leading consumer advocate based in New Zealand.

The WHO got it totally wrong on Covid-19, and it’s no surprise they’ve also got it very wrong with safer nicotine products such as vaping.
Nancy Loucas, consumer advocate
“The WHO got it totally wrong on Covid-19, and it’s no surprise they’ve also got it very wrong with safer nicotine products such as vaping,” she added. “As an ex-smoker, vaping has improved my health and arguably saved my life, yet the WHO and its sponsor American Michael Bloomberg have pressured countries like mine to ban it.”
On Oct. 18, 100 international health experts sent a public letter urging the COP9 parties to take a more positive stance on tobacco harm reduction. That same month, the Global State of Tobacco Harm Reduction (GSTHR) released a report urging the WHO to update its policies, which the GSTHR described as “frozen in time” as they dated from before the arrival on the market of many less-harmful nicotine delivery devices.
A group of tobacco harm reduction experts will hold a round-the-clock broadcasting event Nov. 8-12, to challenge and scrutinize COP9, which will take placed behind closed doors.
November 5, 2021