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  • What Role Does the FCTC Play in Today’s Regulatory Environment?

    What Role Does the FCTC Play in Today’s Regulatory Environment?

    At the Global Tobacco and Nicotine Forum (GTNF) in Brussels, an expert panel explored the growing disconnect between the World Health Organization’s Framework Convention on Tobacco Control (FCTC) and real-world tobacco harm reduction (THR) progress. The session featured Dr. Derek Yach, global health advocate and former WHO executive; Peter Beckett, Co-Founder of Clearing the Air; Dr. Tikki Pang, a professor and former WHO Director of Research Policy and Cooperation; and Dr. Christopher Snowdon, Head of Lifestyle Economics at the Institute of Economic Affairs.

    Yach opened the discussion by criticizing the gap between FCTC policymaking and on-the-ground data. He noted that smoking rates are falling faster in countries embracing harm reduction — such as the U.S., U.K., Japan, South Korea, and New Zealand — than under traditional tobacco control strategies. “If it can happen in Pakistan, it can happen in all of Southeast Asia,” he said. “And if it happens in Southeast Asia, we could be seeing oral cancer in the rearview mirror.” Yach emphasized the need for collaborative public–private partnerships to ensure product safety and credibility, while urging policymakers to move beyond what he called the “distraction” of youth-related arguments that ignore the millions of adult smokers seeking alternatives.

    “It’s not that youth use isn’t important, but putting all the attention on kids doesn’t help for 50 years,” he said. “What about their parents? We could be adding years to their lives right now. [Anti-THR people] just use the youth as a way to divide the argument. We need to shift to the data and take the kid issue off the table.”

    Beckett took a blunt tone, arguing that the FCTC framework is obsolete, exclusive, and lacking transparency. He said the WHO’s current approach alienates the public and damages its credibility, calling the situation “chaotic,” which makes it easier for harm-reduction advocates to push back on. Beckett urged reform-minded countries — especially WHO funders — to “recognize the world as it is” and resist “bullying by overpaid foundations with an agenda,” and accused prohibitionist groups of crossing the line.

    “Ten years ago, they were disingenuous; now they’re straight-up lying,” he said. “I keep hearing the same damn thing. ‘We need to engage with science, we need to be nice to the other side.’ I’m calling bullshit on that. It doesn’t work. There is no amount of science that will do the job. If there was, they’d let me in the bloody room when they have these conversations. We have to recognize this and say enough, and call for a tearing down of the framework in its entirety, because it’s not salvageable.”

    Pang reiterated that many developing countries adopt WHO guidance without generating or analyzing their own data. “They take the easy way out,” he said, “because they lack the capacity to build evidence locally.” Pang pointed to emerging “pockets of positive thinking” among countries that are now re-evaluating WHO recommendations and embracing THR. He called for greater industry unity — across state-owned, multinational, and startup sectors — and stronger alignment with consumer voices. “Consumers are also voters,” he reminded the audience, “and together they can influence policy.”

    Snowdon warned of troubling developments within the WHO, citing “endgame” proposals that reject harm reduction as an industry “con.” He described this as a “quasi-religious mission to destroy all tobacco,” resistant to evidence and reason. Snowdon noted that while grassroots THR advocacy exists, it ironically remains underfunded and overshadowed by well-resourced opposition.

    “We are greatly out-financed. The industry can contribute, but then we get ostracized,” he said. “We have a genuine grassroots movement, but these people have lives to live. They can’t be doing it all the time. Meanwhile, the other side has unlimited resources. The media could be helpful, but they don’t want to risk it.”

    Across the panel, a consensus emerged: the WHO’s FCTC framework risks irrelevance unless it adapts to include harm reduction. Participants agreed that the future of global health policy must be driven by data, innovation, and collaboration rather than ideology.

    The GTNF is the world’s leading annual conference discussing the future of the tobacco and nicotine industries. It is the global exchange for views and ideas between public health experts, government representatives, the industry, and investors.

  • BAT France Points to Anti-Smoking Policy Failure

    BAT France Points to Anti-Smoking Policy Failure

    BAT France told lawmakers today (September 24) that France’s reliance on over-taxation and outright bans risks fueling the illicit nicotine market while failing to cut smoking rates, which remain stubbornly above 30%. “This excessive tax policy has, above all, encouraged criminal, structured, and industrial smuggling,” said Sébastien Charbonneau, director of public and regulatory affairs. He added that the government’s planned ban on tobacco-free nicotine pouches would repeat past mistakes, driving consumers to the black market without advancing public health or protecting minors.

    Instead, BAT France urged a pragmatic approach focused on strict but balanced regulation. The company called for a framework that prohibits sales to minors, limits nicotine content and flavorings, enforces retail controls, and applies substantial penalties for violations.

    “The State has a moral duty to adopt the principle of harm reduction related to smoking to allow adult smokers to have access to alternatives to tobacco, and to do so legally,” Charbonneau said. “All we are asking is to look at the scientific data and regulations that have enabled many countries to achieve their public health objective.”

  • PMI Calls for Smoke-Free Africa 

    PMI Calls for Smoke-Free Africa 

    Philip Morris International (PMI), called for the removal of all obstacles preventing the eradication of smoking in the African continent. The call, made in line with the company’s Tobacco Harm Reduction Program, specifically seeks governments’ policies and actions that are based on current scientific findings, rather than traditions, emotions, and skepticism.

    Speaking at the 2025 Technovation Conference in Cape Town, South Africa, officials of PMI identified a lack of effective government policies, skepticism, and the absence of communication, among other things, as the bane of a smoke-free future in Africa.

    “Innovation has the power to tackle global challenges and, when paired with policy changes, can drive meaningful solutions to worldwide issues,” PMI’s Vice President, Communications and Engagement, Tommaso Di Giovanni said. “However, skepticism toward innovation often results in missed opportunities and stalls progress.” 

     “I think the question we need to ask ourselves is not whether and why, but how Africa should proceed further,” said Andrea Gontkovicova, PMI’s Vice President for Corporate Affairs in the region. “What is the role that we want to take together so that the adult smokers who would otherwise continue smoking are given the information, are given the choice, and are given the products which are significantly better?”  

  • A Broader Approach

    A Broader Approach

    According to experts, established tobacco control measures may be insufficient to achieve the desired reductions in smoking and the associated burden on healthcare systems. | Photo: Taco Tuinstra

    To lower the health and economic burden of smoking, lawmakers should incorporate tobacco harm reduction into their policies.

    By Stefanie Rossel

    The figures are staggering. Smoking cost the world economy an estimated $1.85 trillion, or about 1.8 percent of global gross domestic product (GDP), in 2012, according to a monograph published by the World Health Organization and the U.S. National Cancer Institute in 2016.

    The authors distinguish between direct and indirect costs. Direct costs, which include both healthcare expenses, such as physician fees or medical supplies, and nonhealthcare costs, such as transportation, were approximately $467.3 billion, representing 6.5 percent of global health expenditures, or 0.5 percent of global GDP. Indirect costs, which include the value of productivity and lives lost due to tobacco-related diseases, were an estimated $446.3 billion for disability and $938.6 billion for mortality.

    Low-income and middle-income countries (LMICs) account for almost 40 percent of the expenses incurred globally due to tobacco use, with direct costs representing up to 4 percent of total health spending in these countries. The total economic costs of smoking in LMICs ranged from 1.1 percent to 1.7 percent of GDP in the countries investigated in the report compared with an estimated 2.4 percent in the Americas and 2.5 percent in Europe.

    Some of the data in the monograph dates back to the late 1990s, and it is likely that costs have increased since its publication. While some research released since the publication of the paper suggested that reductions in smoking prevalence would translate into lower healthcare costs quite quickly, these papers focused primarily on the healthcare systems of large, wealthy and technologically advanced societies rather than LMICs, where 80 percent of the world’s smokers live.

    People in LMICs are significantly more likely to die from noncommunicable diseases (NCDs), which include cardiovascular and chronic respiratory diseases, cancer and diabetes, along with mental and neurological conditions. According to the WHO’s website, NCDs account for the deaths of 16 million people prematurely, i.e., before their 70th birthday, worldwide each year.

    Tobacco use represents the leading risk factor for NCDs, ahead of other risk factors such as air pollution, excess sodium intake, alcohol abuse or sedentary lifestyles. According to WHO data, tobacco currently accounts for 8.2 million deaths per year, including the effects of exposure to secondhand smoke, a figure that is projected to increase over the coming years.

    However, the WHO is far from achieving the U.N. Sustainable Development Goal of reducing premature deaths from NCDs by one-third by 2030. Depending on the source (and even the WHO’s numbers are inconsistent here), there are currently between 1.1 billion and 1.3 billion smokers in the world, and the figure is likely to rise, due in part to population growth.

    One of the major weaknesses of prevention is that the benefits take a long time to materialize.

    Focus on Prevention

    “When governments and government agencies lie about the health costs of vaping relative to smoking, they are betraying the trust of the public.”

    According to critics, the WHO’s established tobacco control measures are insufficient to achieve the desired reductions in smoking and the associated burden on healthcare systems. To accelerate progress, policymakers need to fundamentally change their approach, argues Andrzej M. Fal, president of the Polish Society for Public Health, who spoke at the Warsaw Global Forum on Nicotine in June.

    “If we enforce policies that reduce the risk of smoking now, there will be a significant reduction in cancer in 15 [years] to 20 years,” Fal pointed out. Because chronic diseases account for 90 percent of premature deaths, he argued, investing in their prevention is more cost-effective than treatment. The WHO itself recommends prevention as a response to noncommunicable diseases. Fal cited calculations from the global health body showing that every dollar invested in smoking prevention saves $7.43 down the road.

    Based on such considerations, Fal urges authorities to place greater emphasis on prevention and tobacco harm reduction. In 2023, the Polish Parliament analysis office asked Fal to prepare an analysis of the state of the tobacco “epidemic” in Poland. Fal and his co-authors concluded that the country lost 250,000 years of life as a result of tobacco consumption.

    Education about health, Fal suggested, should begin in kindergarten. People who are already ill and refuse to quit smoking should be incentivized to minimalize their risk using less hazardous nicotine-delivery alternatives. “If someone is already seriously ill,” Fal explained, “they can still achieve a better quality of life, live longer, and cost the system less,” he said.

    Fal proposed that each country launch at least one prevention clinic, which should be accessible without referral and would offer access to anti-smoking therapy, nicotine-replacement pharmacotherapy and harm reduction products. The clinics should also be responsible for regional health prevention programs and smoking information campaigns.

    Governments, he suggested, should set tobacco tax rates based on the relative harm of each product category, following the principle of “less harm, less tax.” Taxes on cigarettes—the most harmful tools for tobacco consumption—should rise “radically but progressively,” said Fal, who also called for publicly funded and supervised studies assessing the efficacy, safety and harm reduction in cases where the existing evidence was insufficient.

    One of the major weaknesses of prevention, however, is that the benefits take a long time to materialize. In a U.S. study analyzing the relationship between cigarette sales and lung cancer deaths, for example, it took 20 years for the first measures taken to curb tobacco consumption to show up in lower lung cancer death statistics. That time frame is too long for many lawmakers. “Politicians are not interested in investing in prevention as its benefits are seen long after they have left the government,” said Fal.

    Progress is also obstructed by conflicts of interest. In 2018, he noted, Poland’s tobacco-related health expenditures plus productivity loss were between PLN7 billion ($1.71 billion) and PLZ8 billion in 2018, whereas excise and VAT income from cigarettes amounted to PLN23.5 billion.

    Every dollar invested in smoking prevention saves $7.43 down the road.

    Myopic MPs

    Sinclair Davidson

    All too often, politicians are uninterested in considering the potential unintended consequences of their decisions. For example, Australia’s rules requiring vapers to get a medical prescription and banning imports of disposable e-cigarettes have caused the illicit market to flourish. Ninety-two percent of Australian vapers currently source their vapes from the black market, exposing them to unrelated products. More than 70 tobacco shops have gone up in flames since Health Minister Mark Butler started his crackdown on vapes. Police suspect some of the attacks are carried out by criminal groups as retaliations against store owners who refuse to stock their black market products.

    “Australia tends to pursue harm minimization policies in most areas—except in tobacco and nicotine consumption,” said Sinclair Davidson, professor of institutional economics at RMIT University, Melbourne. “Here, Australia pursues the most socially harmful policies that the so-called public health lobby can dream up. The costs this policy’s short-sightedness imposes on the economy are likely to be large but hidden or indirect. For example, when cigarettes are stolen from convenience stores, this results in insurance costs being increased on those stores and prices being increased for all consumers.

    “Similarly, when criminal profits are increased, criminal behavior in the economy increases. When criminal behavior increases, police budgets increase, resulting in higher taxes for all citizens and higher levels of criminal behavior. We are all victims of crime and criminal behavior—except, of course, the public health lobby, who have built careers off their policy work, and politicians and law enforcement agencies who get expanded budgets and powers as a result of poor policy. It is a vicious cycle of ‘Baptists and bootleggers’ who benefit while the rest of society suffers.”

    Meanwhile, the decline in tobacco tax revenue even as smoking rates have stabilized suggests that people are still smoking—they’re just not smoking legal cigarettes. “The challenges are twofold,” said Davidson. “Government itself has become addicted to tobacco excise revenue, and that source of revenue has become unreliable. The subsidy from smokers to the rest of the population has been captured by criminals. Criminality imposes huge costs on society. This occurs through the normalization of violence and the misallocation of resources from legal activity to illegal activity. Furthermore, criminality has a corrupting influence on law enforcement activities. Poor policy corrodes civil society by undermining public trust in public institutions. When governments and government agencies lie about the health costs of vaping relative to smoking, they are betraying the trust of the public and undermining their moral worth in society.”

    By contrast, Sweden’s success in reducing smoking rates by accommodating snus is a public health success story, according to Davidson. Since 2008, Sweden has slashed its smoking rates from 15 percent to 5.6 percent, according to Smoke Free Sweden. The nation’s smoking prevalence is expected to dip below 5 percent this year, making it the first country to achieve “smoke-free” status as defined by the WHO.

    Sweden’s incidence of cancer is 41 percent lower than in the rest of the EU, corresponding to a 38 percent lower level of total cancer deaths. The country has a 39.6 percent lower rate of death of all tobacco-related diseases compared to the EU average. “I don’t know to what extent Australian consumers are familiar with snus and what the uptake would be—but the principle remains. Low(er) risk products on the market result in consumers substituting away from the high(er) risk products,” said Davidson.

    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.
  • New Study on Harm Reduction Public Policy

    New Study on Harm Reduction Public Policy

    Image: alexskopje

    R Street Institute has released a new report, “Progressive Except for Nicotine: A Discussion of States’ Inconsistent Adoption of Harm Reduction Public Policy.”

    The study examined the harm reduction policy landscape across tobacco, opioids and cannabis in all 50 U.S. states. Researchers identified several important harm reduction-related policies that have varying levels of acceptance/implementation across different states or are currently in legislative flux: tobacco: state and municipal restrictions on electronic nicotine-delivery systems, also known as e-cigarettes or vapes; opioids: states’ authorization of syringe services programs, decriminalization of drug checking equipment, and presence of state-imposed restrictions on methadone that go beyond federal regulations; and cannabis: the legal status of medical and recreational adult-use cannabis markets in each state.

    Researchers then used this information to rank states as “restrictive,” “moderate” or “permissive” on harm reduction with regard to each substance. These rankings were quantitatively compared for all states, and states deemed “restrictive” on at least one substance were qualitatively examined. 

    The report found that while some states support one type of harm reduction, those same states may actively oppose another type of harm reduction. The report also showed that the five states most restrictive of reduced-risk nicotine products in tobacco harm reduction are California, Massachusetts, New Jersey, New York and Rhode Island, and these states are relatively “permissive” when it comes to opioid harm reduction and cannabis use.

    The researchers have suggested that lawmakers reflect on the inconsistencies between harm reduction policies across substances and put political motivations aside to support harm reduction across all substances.

  • Taiwan: Stakeholders Debate Policy Proposals

    Taiwan: Stakeholders Debate Policy Proposals

    Photo: Andrii Yalanskyi | Adobe Stock

    A demonstrative policy debate event on whether e-cigarettes should be regulated was held on March 8, 2022, in Taipei, showing how different public policy viewpoints can be rationally discussed, according to The Taipei Times. The debate was held by the Chinese Debate Promotion Association (CDPA) at the Taipei NGO House.

    CDPA Chairman and Founder Chia Pei-te said that the Executive Yuan in January approved a draft amendment to the Tobacco Hazards Prevention Act proposed by the Ministry of Health and Welfare for legislative review. The proposed regulations on emerging tobacco products have sparked discussions, he said.

    The amendment would classify emerging tobacco products as “tobacco-like products” and “designated tobacco products.” E-cigarettes would be classified as “tobacco-like products” and be fully banned while heated-tobacco products would be classified as “designated tobacco products” and be subject to regulation.

    The reasoning behind banning e-cigarettes includes keeping curious teenagers away from the products, preventing consumers from adding nicotine to e-cigarette e-liquids and lowering the risk of teenage users turning to smoking.

    The debate participants went back and forth discussing the pros and cons of regulating e-cigarettes versus banning them, bringing up subjects such as public health, tax revenue options and teenage use.

    National Yang Ming Chiao Tung University (NYCU) College of Pharmaceutical Sciences Dean Kang Jaw-jou said that he was moved by opinions for and against e-cigarettes. He said the affirmative side proposed to directly manage e-cigarette use through regulations and an approval system while the opposing side stressed their attitude to life—banning a substance if the public consensus deems it harmful to society.

    Many aspects of the topic can be argued, but e-cigarettes can cause negative health effects, and supporters and opponents must clearly present this fact to the public in further discussions, stated Wang Hsiang-tsui, NYCU Faculty of Pharmacy associate professor.