Tag: Framework Convention on Tobacco Control

  • The Stubborn Squad

    The Stubborn Squad

    Photo: Olrat

    In trying to engineer consumer choices, COP9 delegates persist in their Luddite approach.

    By George Gay

    A lot of silly comparisons have been drawn between the October/November Conference of the Parties (COP26) to the Framework Convention on Climate Control and the November Conference of the Parties (COP9) to the Framework Convention on Tobacco Control (FCTC). One even had it that the two were of equal importance. No. The first concerned an existential crisis for humanity. The second seemingly dallied with dissonance theory as it examined how a single organization could, at one and the same time, try to stop people smoking while strengthening the supply chains that get cigarettes into their hands. In my view, the difference in importance between the two was such that, given COP26 ended with few firm significant commitments, and, consequently, the earth is set to become uninhabitable by humans, the battle of words waged over COP9 amounted to little more than the proverbial fight between two bald men over a comb.

    But others clearly thought differently, so the pressure on the Parties to the FCTC was intense ahead of and during this year’s COP, or as intense as it could have been given the secretive nature of the event. Perhaps the intensity was ramped up because the tobacco harm reduction (THR) deniers at the FCTC, like the climate change deniers, were starting to feel the heat; were starting to show signs that they were coming to realize they had lost or were losing the argument; and because those who support a THR strategy were glimpsing light at the end of the tunnel. Perhaps, too, it was because the Covid-19 pandemic had made people more familiar and comfortable with internet meetings and performances, which enabled THR advocates and consumers to broadcast their side of the argument throughout COP9, while the quit-or-die protagonists and THR deniers at the FCTC, as has become usual, were hunkered down, almost incommunicado—shut off from the infectious ideas and opinions of others, including those whose lives they were attempting to manipulate and control.

    It is not without irony that the failures of the WHO in respect of the devastating pandemic led to changes to the COP9 and MOP2 meetings.

    Of course, there was some official communication around COP9 as when in August the Convention Secretariat issued a media release blaming the Covid-19 pandemic for the fact that planned face-to-face sessions at The Hague, Netherlands, had had to be ditched in favor of virtual meetings; on Nov. 8–13 in the case of COP9; and on Nov. 15–18 in the case of the Meeting of the Parties (MOP2) to the Protocol to Eliminate Illicit Trade in Tobacco Products. It is not without irony that the failures of the World Health Organization—along with those of many governments, institutions, companies and individuals—in respect of the devastating pandemic led to changes to the COP9 and MOP2 meetings. Perhaps if the WHO had had its eye more on viruses than on tobacco … Oh, never mind. But it is worth noting here that in the same release, the Secretariat announced it had “released the first group of documents…” relating to COP9, because the use of the word “released,” rather than, say, “published,” is instructive as to who seems to be in the driving seat at the FCTC—and it isn’t the Parties.

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    Influencing Product Choices

    Looked at one way, the fighting at and on the fringes of COP9 was over the promotion of different products and methods aimed at influencing the consumer product choices made by smokers who are being told, by those who claim to know best, that they, the smokers, should quit the product they are currently using, even though its consumption is perfectly legal. It makes me wonder how many of those calling for smokers to quit their habit drink alcohol, which is probably, in the West, the most socially destructive legal consumer product available—the only legal consumer product I can think of that dulls the brain when used as intended by manufacturers. Hypocrisy, like alcohol, is legal and is leaned upon heavily.

    The fighting is justified by both sides on the grounds that it is over the most efficacious way of getting smokers to quit and thereby adding a few more years to their lives. Whether all smokers want to make this trade-off seems to be seen as of little importance and, in this respect, I would like to applaud Clive Bates for including the following gentle but important reminder in his pre-COP9 published piece “Prohibitionists at Work: How the WHO Damages Public Health Through Hostility to Tobacco Harm Reduction”: “Not everything in life is subordinated to maximizing life expectancy.” Drinkers, of course, will be aware of this.

    What we are witnessing is a commercial fight between the purveyors of nicotine-replacement therapy products, which are promoted by the WHO and not discounted by THR supporters, and the purveyors of THR products, which are frowned upon by the WHO.

    In reality, and in part, what we are witnessing is a commercial fight between the purveyors of nicotine-replacement therapy products, which are promoted by the WHO and not discounted by THR supporters, and the purveyors of THR products, which are frowned upon by the WHO. But, to my way of thinking, there is a vital difference between the approaches of the two sides. I am not going to go into details here because most of the relevant arguments are already familiar to readers of this magazine and because anybody who wants to refresh their knowledge may visit Bates’ excellent piece. But at its most basic, the difference amounts to the fact that those pushing the THR message are offering less risky and hugely less risky substitute products to those smokers who are considering or who have decided they want to quit smoking highly risky combustibles and have not been able to do so using other methods, while the FCTC is intent on discouraging the use of THR products and, instead, forcing all smokers to quit, largely through pricing them out of the market by encouraging governments to apply unconscionable levels of taxes. Unfortunately, some of those who support THR are not above calling for higher taxes on combustibles or describing tobacco tax hikes as “progress” or “success.”

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    Sensible Voices

    Seemingly, the main item to have emerged from the bureaucratic thicket of the COP9 concerned a decision to launch an investment fund that will offer another source of financial support. “This lays a foundation for financial stability for the future implementation of the WHO FCTC,” a post-conference press note stated. “The fund will complement existing revenue received from Parties through assessed contributions and extra budgetary support.”

    I don’t know how this fund will be operated and possibly wouldn’t understand it if I were to be told, but something about the announcement strikes me as important. It seems to me to indicate the Secretariat is perhaps concerned about future contributions from the Parties, and, if this is true, I would say it shows the glimmer of an unusual connection with reality. Sensible voices are starting to be raised. The Philippines’ foreign affairs secretary, Teodoro Locsin Jr., reportedly told the conference that the latest scientific information must be considered in trying to solve the global smoking problem, adding that a balanced and evidence-based approach to safer nicotine products was needed. The Philippines was making progress in moving away from harmful products by introducing products with similar satisfaction but causing far less harm.

    At the same time, if the new financial arrangements are predicted to make the FCTC’s star shine brighter in the future, I think the observers are looking through the wrong end of the telescope, unless, at the same time, the FCTC shifts its focus from quit-or-die to harm reduction. The Philippines’ delegation bravely set the scene for a new direction that, if it is not taken, will see the FCTC’s star implode under the weight of its own contradictions. For instance, the U.K. cannot in all conscience turn up in Panama in 2023, where COP10 is scheduled to be held, showing support for a quit-or-die policy while prescribing harm reduction devices at home. And other countries will surely follow this lead. The Secretariat and its allies are defying logic, and it is possible to do that only for so long. I would venture to say their time is running out.

    A Healthy Body Securing the Supply Chain

    Meanwhile, it surely has to be the case that the three-year-old MOP will collapse even though it, too, is to seek out a new funding stream. The idea that a so-called world health organization is involved in policing the illegal trade in tobacco products again defies logic and seems to hark back to the time when the U.S. Food and Drug Administration seemed to become directly involved (it might still be so involved) in sending underage people into shops to catch retailers selling tobacco products to such people.

    It might take a little time for the MOP nonsense to be exposed, of course, because there is unlikely to be any opposition from the tobacco industry. A press note published to coincide with the opening day of MOP2 said, in part, “During this meeting, Parties will discuss a number of issues, including ways of securing the supply chain of tobacco products….” You have to wonder whether this was meant as a joke. An international health organization is bent on securing the supply chain of tobacco products? Really?

    Certainly, the MOP is a confused entity, partly because of the hopelessly optimistic goal built into the name of the protocol that it is supposed to oversee. Announcing MOP2, a press note referred in the first two paragraphs to its aims as being eliminating, which is in the name, but also stopping and combatting the illegal trade of tobacco products. I guess such vagueness helps guard against the time that an audit of progress is made.

    As far as I could see, MOP2 ended with little more than a few vague promises whose meaninglessness was underscored by the overuse of the word important. “Importantly, MOP2 agreed to strengthen international cooperation to ensure greater assistance between Parties—an important step that is expected to accelerate the adoption of best practices and support the introduction of innovations,” a closing note said. “The Parties also adopted a strategy for mechanisms of assistance and mobilization of financial resources to deepen the implementation of the Protocol.” Hmm.

    An international health organization is bent on securing the supply chain of tobacco products? Really?

    Having said this, I have some sympathy for the WHO. Once most countries had signed up to the ludicrous idea that a global health organization should become involved through the FCTC in trying, among other things, to engineer consumer choices, it was headed into unfamiliar territory. However, it has only itself to blame for the Luddite approach it has taken in the face of the development of new generation tobacco and nicotine products that are far less risky than are combustible cigarettes and that for many smokers provide a satisfactory substitute for combustibles.

    OK, some might argue—in a near-perfect world, but one in which the rights of cigarette smokers were, as usual, pushed to the side—that the WHO might be justified in taking the actions it has. After all, it claims the global prevalence of tobacco use among people 15 years of age and older decreased from 29 percent in 2005 to 22 percent in 2019 and will continue to decrease. Of course, it would be impossible to say why this decrease has occurred, but even if you accept that it is down to FCTC strategies, that doesn’t mean those strategies should be continued exclusively in the future if there are new strategies that can speed things along.

    In addition, we are in the grip of a global pandemic, which has, in general, been poorly handled and led to the deaths of millions of people; we are likely to be ravaged by other pandemics because no meaningful preventative measures are being taken; we are facing an existential environmental crisis; and we are dying in ever-increasing numbers from a global pollution pandemic. At such a time, we need the WHO to focus on risks such as these because these are the risks over which people have little or no control. Smoking is a choice.

  • COP9 Agrees to Strengthen Funding

    COP9 Agrees to Strengthen Funding

    Photo: Maksym Yemelyanov

    The Ninth Session of the Conference of the Parties (COP9) to the WHO Framework Convention on Tobacco Control has closed with an agreement to embark on an innovative multi-million-dollar financial plan to strengthen global tobacco control measures

    According to the WHO, a key milestone arising from COP9 is the decision to move forward with the development and launch of an investment fund that will offer a third source of support to help global tobacco control efforts. “This lays a foundation for financial stability for the future implementation of the FCTC,” the global health body wrote in a press note. The fund will complement existing revenue received from Parties through assessed contributions and extra budgetary support.

    This new initiative will source financial contributions beyond the traditional health sector, establishing a capital investment fund, the earned revenue of which will be used to support the activities of the convention. Recognizing the unique skills required to manage and sustain the fund, the governing body of the FCTC will be seeking the guidance of the World Bank, and will create an oversight committee, comprised of experts in financial and investment management representing the six WHO Regions and including observers from civil society to help guide the Fund.

    The event also saw the highest level of participation since the initiation of the COPs. In this week’s event, 161 Parties were present.

    For the first time, the whole of COP9 was open to the media, who observed sessions where tobacco control measures were discussed between the Parties, according to the WHO.

    “This demonstrates the enormous power of this COP9 where 161 sovereign states debated for four and a half days, and by consensus decided which topics they wanted to decide upon in this session, and which others they want to defer to COP 10,” said Adriana Blanco Marquizo, head of the convention secretariat.

    COP9 also adopted the “Declaration on WHO FCTC and recovery from the Covid-19 pandemic”, proposed by Iran, and co-sponsored by a broad group of parties. It stresses the need to protect public health policy from the commercial and vested interests of the tobacco industry, and that tobacco control measures, particularly increases in tobacco taxes, should be an integral part in pandemic recovery efforts.

     

  • New Report Questions WHO’s Vaping Stance

    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.

    “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.”

  • WHO Tobacco Control Conference Kicks Off

    WHO Tobacco Control Conference Kicks Off

    Image: Tobacco Reporter archive

    The Conference of the Parties to the WHO Framework Convention for Tobacco Control (FCTC) today opens its ninth session (COP9). One significant point to be discussed by the Parties is a potential new funding strategy, seen as a means of strengthening and expanding the support that can be offered to Parties of the global health treaty.

    Parties at COP9 are expected to consider how to address a common problem described by many countries—the lack of sufficient financial resources to strengthen tobacco control measures. This will mean a plan to establish a capital investment fund is high on the COP9 agenda. The Parties will decide on the adoption of a mechanism for new income streams to help fight the tobacco epidemic.

    The proposal offers the opportunity to raise a targeted $50 million for the FCTC. A similar fund will be proposed for adoption at the second session of the Meeting of the Parties to the Protocol to Eliminate Illicit Trade in Tobacco Products to take place later this month—but in the case of the Protocol, the fund proposed will be for $25 million to strengthen implementation of that treaty.

    In a press release, the WHO said it would continue pushing forward with comprehensive implementation of the FCTC as the real solution to the tobacco epidemic, despite what it described as tobacco industry efforts to “stir up confusion and falsely parade itself as a solution to harmful tobacco consumption.”

    The COP9 discussions Nov. 8-13 bring together Parties, representing countries, United Nations agencies, other intergovernmental organizations and civil society. The participants will be exchanging their experiences in implementing tobacco control measures and reducing the prevalence of tobacco use. They will also be looking at strategies that improve tobacco control efforts, amid what the WHO describes as “attempts by the tobacco industry to interfere in ending the tobacco epidemic that is killing over 8 million people annually.”

    During the conference, delegates will also be evaluating the most recent Global Progress Report, which was launched last week. A total of 148 Parties reported on the comprehensive tobacco control measures contained in the treaty. For example, in relation to progress on Article 11, two-thirds of Parties confirmed that the required health warnings are being displayed on tobacco product packaging and, 17 countries confirmed that they have adopted the requirements for plain packaging of tobacco products.

    Parties have reported that they have struggled to introduce comprehensive advertising, promotion and sponsorship bans. Many complained of persisting interference in policymaking by the tobacco industry.

    In her keynote speech at the opening of COP9, Adriana Blanco Marquizo, head of the Convention Secretariat referred to the ongoing COP 26, on Climate Change. There are important parallels between the Framework Convention on Climate Change and the WHO FCTC, she noted.

    “Both treaties aim to protect present and future generations,” said Blanco Marquizo. “It’s clear that tobacco damages the environment throughout its life cycle, from crop to post-consumer waste, contributing to deforestation, desertification, greenhouse emissions and plastic contamination. But probably the most important point shared at both COPs, is that the tobacco epidemic and climate change are both manmade and preventable.”

    Critics, by contrast, focused on the differences between the two COPs, with the Climate Change gathering welcoming public scrutiny and industry input, and COP9 convening behind close doors and banning dialogue with the industry.

    Immediately after COP9, the second Meeting of the Parties to the Protocol to Eliminate Illicit Trade in Tobacco Products will be convened, Nov. 15-18. The Protocol is a separate treaty expanding Article 15 of FCTC.

  • COP9 Coverage

    COP9 Coverage

    The Stubborn Squad

    In trying to engineer consumer choices, COP9 delegates persist in their Luddite approach.

    A Tale of Two COPs

    The striking differences between this month’s UN climate gathering and the FCTC COP9.

    A Better Treaty

    GTNF panelists offer suggestions for transforming the FCTC ahead of the ninthe Conference of the Parties.

  • WHO Urged to Adjust its Vapor Stance

    WHO Urged to Adjust its Vapor Stance

    Photo: ekim

    One hundred tobacco harm reduction (THR) experts have published a joint letter challenging the World Health Organization’s (WHO) approach to tobacco science and policy. The group is urging members of the Ninth Session of the Conference of the Parties (COP-9) of the Framework Convention on Tobacco Control (FCTC) to encourage the WHO to support and promote the inclusion of tobacco harm reduction into its regulatory advisements.

    “Smoke-free nicotine products offer a promising route to reducing the harms arising from smoking. There is compelling evidence that smoke-free products are much less harmful than cigarettes and that they can displace smoking for individuals and at the population level,” the letter states. “Regrettably, WHO has been dismissive of the potential to transform the tobacco market from high-risk to low-risk products. WHO is rejecting a public health strategy that could avoid millions of smoking-related deaths.”

    The letter was published on Oct. 18 and will be sent to COP-9 delegates. In a joint statement, Ruth Bonita, former director of WHO Department of NCD Surveillance, and Robert Beaglehole, former director of the WHO Department of Chronic Disease Prevention and Health Promotion, stated that they were “extremely disappointed by WHO’s illogical and perverse approach” to reduced-harm nicotine delivery products, such as vaping.

    “A key challenge in global tobacco control is to assist cigarette smokers to transition from burnt tobacco products to much less harmful options that provide the nicotine without the toxic smoke,” the statement reads. “WHO’s continuing disregard of the wealth of evidence on the value of these products is condemning millions of smokers to preventable disease and premature death.”

    The letter goes on to make seven points about the current vaping regulatory environment, such as the value of vaping in THR and the unintended consequences of poor regulatory policies. The authors then go on to make six suggestions for the WHO to consider:

    • Make tobacco harm reduction a component of the global strategy to meet the Sustainable Development Goals for health, notably SDG 3.4 on non-communicable diseases.
    • Insist that any WHO policy analysis makes a proper assessment of benefits to smokers or would-be smokers, including adolescents, as well as risks to users and non-users of these products.
    • Require any policy proposals, particularly prohibitions, to reflect the risks of unintended consequences, including potential increases in smoking and other adverse responses.
    • Properly apply Article 5.3 of the FCTC to address genuine tobacco industry malpractice, but not to create a counterproductive barrier to reduced-risk products that have public health benefits or to prevent critical assessment of industry data strictly on its scientific merits.
    • Make the FCTC negotiations more open to stakeholders with harm-reduction perspectives, including consumers, public health experts, and some businesses with significant specialized knowledge not held within the traditional tobacco control community.
    • Initiate an independent review of WHO and the FCTC approach to tobacco policy in the context of the SDGs. Such a review could address the interpretation and use of science, the quality of policy advice, stakeholder engagement, and accountability and governance. The Independent Panel for Pandemic Preparedness and Response (IPPPR), initiated to evaluate the response to the COVID-19 pandemic, offers such a model.

    In a separate statement, David Sweanor, adjunct professor of law, chair of the Advisory Board of the Centre for Health Law, Policy and Ethics University of Ottawa, Canada, said that effective public health efforts need to be based on science, reason and humanism. Instead, he noted, the WHO is aligning itself against all three when dealing with nicotine.

    “The result is that one of the greatest opportunities to improve global health, separating nicotine use from smoke inhalation, is being squandered. Global trust in health authorities, and the WHO in particular, has never been so important,” the statement reads. “Yet the WHO is abandoning science, rationality and humanism on nicotine and instead apparently pursuing the moralistic abstinence-only agenda of external funders. This is a public health tragedy that extends well beyond the unnecessary sickening of the billion-plus people who smoke cigarettes.”

  • Experts Challenge WHO Stance on Safer Nicotine

    Experts Challenge WHO Stance on Safer Nicotine

    Photo: Tom

    The Global State of Tobacco Harm Reduction (GSTHR), a Knowledge-Action-Change (KAC) project, launches a new series of briefing papers ahead of the publication of its latest report, Fighting The Last War: The WHO and International Tobacco Control, on Oct. 27.

    The suite of new GSTHR publications aims to draw attention to, and challenge the direction of travel of, the Framework Convention on Tobacco Control (FCTC) ninth Conference of the Parties (COP9), a major global meeting on tackling smoking. The meeting is being held virtually in early November. According to the GSTHR, the FCTC agenda and briefing papers indicate the FCTC secretariat and leadership are continuing to urge parties against the adoption of tobacco harm reduction approaches that could help save millions of lives.

    The GSTHR briefing papers offer analyses, commentaries or explainers on topics related to tobacco harm reduction and its role in combating the death and disease caused by smoking.

    The first paper provides a brief overview of both the FCTC and the Conference of the Parties biennial meetings, explaining their role in global tobacco and nicotine policy as well as highlighting some of the problematic elements of their current operation. A deeper analysis of these issues will be revealed when Fighting The Last War is published later in the month.

    The second GSTHR briefing paper focuses on the U.K.’s potential leadership role at COP9. According to the GSTHR, the U.K. has successfully implemented important aspects of a domestic tobacco harm reduction policy while retaining a strong tobacco control record. Currently, the FCTC project does not reflect the U.K. approach—yet the U.K. is one of the most consistent and generous financial backers of both the FCTC and the WHO. At COP9, the paper argues, the U.K. must be prepared to take a strong line and advocate for policies it has enacted that are demonstrably increasing the numbers of people successfully quitting smoking.

    These issues and more will be explored in depth in the GSTHR’s forthcoming report, to be published on Oct. 27 at a hybrid launch event, free to attend online. In Fighting The Last War: The WHO and International Tobacco Control, the report’s author, Harry Shapiro, takes a close look at the history, development and often secretive processes of the FCTC COP, its early battles with the tobacco industry—and the range of influences shaping international tobacco control’s response to safer nicotine products in 2021.

    The report launch will be broadcast on Oct. 27 from the Kia Oval in London. Two roundtable sessions will be livestreamed from 11 a.m. British Summer Time, with time allowed for questions from those watching in the room and from afar. Will Godfrey of Filter will host the first session, “The FCTC: Past, Present and Future,” which features Harry Shapiro, KAC report author; Derek Yach, Foundation for a Smoke-Free World, former WHO cabinet director and executive director for noncommunicable diseases and mental health; and Tom Gleeson of the New Nicotine Alliance Ireland.

    The second session will be hosted by Jeannie Cameron of JCIC Consulting and will be centered on the “Challenges to making the FCTC an inclusive international framework convention.” Audience members will hear from Ethan Nadelmann, founder of the Drug Policy Alliance; Nataliia Toropova from Healthy Initiatives and Professor Gerry Stimson, director of KAC.

    Parties to the FCTC must seize the opportunity to consider evidence from countries where tobacco harm reduction is succeeding, including the U.K., New Zealand, Sweden, Norway and Japan.

    “We’re gravely concerned by the WHO’s continued rejection of tobacco harm reduction,” said Stimson. “It already accepts harm reduction as a valid evidence-based public health intervention for drug use and HIV/AIDS. Harm reduction is explicitly named as one of three tobacco control strategies in the opening lines of the Framework Convention on Tobacco Control. Adoption could hasten the end of the public health crisis caused by smoking.

    “Instead, the WHO rejects and, worse, repeatedly misinforms the public about safer nicotine products, demonstrating a disregard both for the lives of over one billion adult smokers and the eight million deaths each year due to smoking. Parties to the FCTC must seize the opportunity at COP9 to consider evidence from countries where tobacco harm reduction is succeeding, including the U.K., New Zealand, Sweden, Norway and Japan—and ask why the WHO and its influential financial backers are refusing to do the same.” 

  • FCTC Conference of the Parties Moves Online

    FCTC Conference of the Parties Moves Online

    Photo: Olrat

    The Ninth Session of the Conference of the Parties (COP9) to the World Health Organization Framework Convention on Tobacco Control (FCTC) and the Second Session of the Meeting of the Parties (MOP2) to the Protocol to Eliminate Illicit Trade in Tobacco Products will take place virtually, with COP9 running Nov. 8–13, 2021, and MOP2 running Nov. 15–18, 2021.

    The meetings were originally scheduled to take place in The Hague. In view of the ongoing Covid-19 pandemic and related travel restrictions, the WHO has decided to move the events online.

    The virtual format means participants will consider abridged agendas, the WHO wrote on its website. Several issues, including ones relating to tobacco harm reduction, will be deferred for discussion until the next regular meeting of the governing body, COP10, in 2023.