Tag: World Health Organization

  • THR Activists to Broadcast During COP9

    THR Activists to Broadcast During COP9

    Image: sCOPe
    Nancy Loucas

    A group of tobacco harm reduction experts will hold a round-the-clock broadcasting event Nov. 8-12, coinciding with the Ninth Session of the Conference of the Parties (COP9) to the World health Organization Framework Convention on Tobacco Control (FCTC).

    Dubbed “sCOPe,” or “streaming Consumers On Point everywhere,” the five-day livestream will be simulcast via YouTube and Facebook. Presenters and panelists will challenge and scrutinize COP9, questioning, for example, who is influencing and funding its efforts to demonize vaping.

    “Before the Covid-19 pandemic, consumers were planning to front up to COP in person and show media our increasing anger for being shut out, once again, from the proceedings,” said sCOPe organizer Nancy Loucas, executive coordinator of the Coalition of Asia Pacific Harm Reduction Advocates. “The FCTC’s decision to delay COP9 and host it exclusively online, with no discussions to be publicly released, meant consumers had to take alternative action. Hence, the development of sCOPe,”

    “sCOPe is our response to being excluded from the table, as the main stakeholders, of the discussion and decision-making process that directly impacts our health and our right to make informed decisions,” she said.

  • 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.”

  • 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.

  • WHO Reiterates Stance Against Vaping

    WHO Reiterates Stance Against Vaping

    While progress has been made in the fight against tobacco use, the marketing of e-cigarettes toward young people could have harmful health outcomes going forward, according to World Health Organization Director-General Tedros Adhanom Ghebreyesus.

    Ghebreyesus gave the warning in a statement along with the release of the “WHO report on the global tobacco epidemic 2021,” the eighth study from the United Nations public health agency measuring progress on efforts to curb the sale of tobacco and nicotine products worldwide.

    While the report found that more than four times as many people are covered under WHO-recommended tobacco control measures than in 2007, it expressed concern that children who use “electronic nicotine-delivery systems, such as e-cigarettes, are up to three times more likely to use tobacco products in the future.”

    “Nicotine is highly addictive. Electronic nicotine-delivery systems are harmful and must be better regulated,” Tedros said.

    He went on to argue that in places where e-cigarettes are not banned, “governments should adopt appropriate policies to protect their populations from the harms of electronic nicotine-delivery systems and to prevent their uptake by children, adolescents and other vulnerable groups.”

    Over 100 million ex-smokers use reduced-risk products and the WHO should be taking advantage of massive investment in the sector by encouraging governments to provide an incentivized regulatory framework to enable greater expansion.

    Tobacco harm reduction advocates and vaping industry representatives denounced the WHO report as “nonsensical and dangerous.”

    “The WHO has a long-standing anti-vaping stance and this latest attack on a sector that is literally saving millions of lives worldwide flies in the face of scientific evidence, common sense and harm reduction,” said John Dunne, director general of the U.K. Vaping Industry Association (UKVIA), in a statement.

    “This report demonstrates that, sadly, the WHO still doesn’t understand the fundamental difference between addiction to tobacco smoking, which kills millions of people every year, and addiction to nicotine, which doesn’t,” said John Britton, professor of epidemiology at the University of Nottingham.

    “The WHO is also evidently still content with the hypocrisy of adopting a position which recommends the use of medicinal nicotine products to treat addiction to smoking but advocates prohibition of consumer nicotine products which do the same thing but better.”

    Derek Yach, president of the Foundation for a Smoke-Free World, said the WHO’s comments were “fundamentally flawed.” “The exceptional growth of next-generation devices offers the WHO a real opportunity to tackle combustible consumption once and for all,” he said.

    “Over 100 million ex-smokers use reduced-risk products and the WHO should be taking advantage of massive investment in the sector by encouraging governments to provide an incentivized regulatory framework to enable greater expansion.”

    David Jones, MP, who sits on the U.K. All-Party Parliamentary Group for Smoking and Health, described the WHO’s opposition to all smoking alternatives, not just vaping, as “bizarre.”

    “Our advice remains that people who smoke are better to switch completely to vaping,” he said. “That opinion, however, is not shared by the WHO, which has long pursued an almost pathological campaign against e-cigarettes.”

  • WHO Details “Attempts to Avoid Regulation”

    WHO Details “Attempts to Avoid Regulation”

    Photo: Olrat

    The World Health Organization has published a report detailing what it describes as attempts by manufacturers to avoid regulation of e-cigarettes and heated-tobacco products.

    Titled “Litigation relevant to regulation of novel and emerging nicotine and tobacco products: comparison across jurisdictions,” the report offers governments examples of the legal arguments that the industry has used in attempts to minimize regulation as well as how courts have addressed those arguments.

    The emergence of products such as heated-tobacco products (HTPs) and electronic nicotine-delivery systems (ENDS) and their market growth has raised questions about how they should be regulated and how that regulation might affect comprehensive tobacco control.

    The WHO previously published its position on regulation of these products but has not addressed legal issues, such as how those regulations are being challenged in different jurisdictions. The new report and the accompanying case summaries close this gap and provide the facts, discussion of legal issues, arguments advanced and the reasoning of the courts.

    The key messages highlighted in the publication are:

    • ENDS and HTP manufacturers attempt to avoid products being regulated so as to fall within regulatory or legislative gaps.
    • Manufacturers can be expected to deploy arguments concerning the relative risk of different product categories and the need for coherent regulation along a continuum of risk.
    • Not all courts are receptive to arguments about relative risk, either because regulations are justified by reference to absolute risk or because the concept of relative risk must be judged at the population level and taking into account factors beyond relative toxicity.
    • Technological advances employed for the manufacture of novel and emerging nicotine and tobacco products will raise questions of whether a product falls within the ambit of the national legislation of the country.
    • There are relatively few cases addressing misleading marketing of ENDS, or enforcing restrictions on advertising, promotion and sponsorship, but important cases have been decided, including on how social media posts may constitute advertising and on whether advertising of an HTP device also constitutes advertising of a tobacco product.
  • Countries Recognized for Anti-Smoking Efforts

    Countries Recognized for Anti-Smoking Efforts

    Photo: phitak

    The World Health Organization (WHO) bestowed its World No-Tobacco Day Awards for 2021 in the Americas to three Costa Rican institutions, the ministries of health in Saint Lucia and Paraguay, the Uruguayan National Resource Fund, two California cities and a Brazilian doctor, according to the Pan American Health Organization.

    The winners, selected from nominations received in response to a public call, achieved key advances in tobacco control in their countries, according to the global health body. The awards are part of global tobacco control efforts recognized on World No-Tobacco Day every year.

    A shared award was given to Costa Rica’s mSalud Institutional Team, which comprises three institutions formed by the Ministry of Health, the Costa Rican Social Security Fund and the Institute on Alcoholism and Drug Dependence. The mSalud Team received the award for their role in expanding quit-tobacco services through development of online tools.

    Uruguay’s National Resource Fund received the award for its role in the National Network of Smoking Cessation Units. The network arose out of the Tobacco Treatment Program, which the Resource Fund created in 2004. The Resource Fund is now responsible for coordinating, evaluating and supporting the network, which has played a key role in increasing access to quit-tobacco services throughout the country.

    The award was given to Tania Cavalcante, an oncologist at Brazil’s National Cancer Institute and Executive Secretary of the National Committee for the Implementation of the Framework Convention on Tobacco Control in Brazil. She received it for her lifelong contribution to effective tobacco control policy in Brazil and for her globally impactful work on implementation of the WHO Framework Convention on Tobacco Control (FCTC). Cavalcante also has been instrumental in facilitating countries’ exchanges of experiences in tobacco control in Latin America and among Portuguese-speaking countries.

    Saint Lucia’s Ministry of Health and Wellness received the award for its role in adoption in June 2020 of the Public Health (Smoking Control) Regulations, Statutory Instrument, 2020, No. 81. The regulation establishes a smoking ban in enclosed public and working places and on public transport. The regulation covers electronic cigarettes and prohibition of the sale of tobacco products in places such as health, sport, government, childcare, educational and religious facilities. With the adoption, St. Lucia became the eighth country in the Caribbean and the 22nd in the Americas to adopt regulation in keeping with Article 8 of the FCTC, which asserts that people should be protected against tobacco smoke in indoor public places, indoor workplaces and public transportation.

    Paraguay’s Ministry of Public Health and Social Welfare received the award for its role in Decree No. 4624, which establishes that cigarettes, heated-tobacco products or electronic cigarettes can only be consumed in open-air spaces without crowds. With the decree, Paraguay joins the rest of South American countries in following Article 8 of the FCTC to create a smoke-free region.

    The California cities of Beverly Hills and Manhattan Beach shared the award for their ban on the sale of tobacco products. According to the WHO, their actions serve as proof of concept for Project Sunset, a global effort to phase out sale of commercial combustible tobacco products, including alternative nicotine-delivery systems. California has since set a goal of eliminating tobacco use by 2035. Through this initiative, Beverly Hills and Manhattan Beach are going one step beyond established measures to mitigate and reduce consumption of tobacco, the global health body said.

  • WHO Reiterates its Opposition to THR

    WHO Reiterates its Opposition to THR

    Photo: Olrat

    In the runup to World No Tobacco Day on May 31, the World Health Organization (WHO) has reasserted its abstinence-only approach to nicotine.

    In a May 19 press release titled “Quit tobacco to be a winner,” the WHO said that the tobacco industry has “promoted e-cigarettes as cessation aids under the guises of contributing to global tobacco control” while employing “strategic marketing tactics to hook children on this same portfolio of products, making them available in over 15,000 attractive flavors.”

    The agency also insisted that the scientific evidence on e-cigarettes as cessation aids was inconclusive and that “switching from conventional tobacco products to e-cigarettes is not quitting.”

    “We must be guided by science and evidence, not the marketing campaigns of the tobacco industry—the same industry that has engaged in decades of lies and deceit to sell products that have killed hundreds of millions of people,” said WHO Director-General Tedros Adhanom Ghebreyesus. “E-cigarettes generate toxic chemicals, which have been linked to harmful health effects, such as cardiovascular disease and lung disorders.”

    We must be guided by science and evidence, not the marketing campaigns of the tobacco industry.

    The global health body also reiterated its commitment to excluding the tobacco industry from the debate through article 5.3 of the Framework Convention on Tobacco Control.

    “The tobacco industry is the single greatest barrier to reducing deaths caused by tobacco use,” the WHO wrote. “Their interests are irreconcilably opposed to promoting public health and point to a critical need to keep them out of global tobacco control efforts.”

    The organization also cited the United Nations Global Compact, which banned the tobacco industry from participation in 2017. “In line with Article 5.3, industry has been entirely excluded from the U.N. system, and its agencies have been urged to devise strategies to prevent industry interference,” the WHO wrote.

  • Vaping Group Supports Call to Defund WHO

    Vaping Group Supports Call to Defund WHO

    John Dunne (Photo: UKVIA)

    The U.K. Vaping Industry Association (UKVIA) has joined the chorus of voices condemning the World Health Organization (WHO) for its urging of countries to take an aggressive anti-vaping stance ahead of a crucial health summit later this year.

    According to leaked documents reported in the Daily Express, the WHO plans to use November’s COP9 summit in the Netherlands as a platform to tell leading international health figures that e-cigarettes are as dangerous as smoking tobacco.

    The UKVIA joins the criticism of the WHO by the All-Party Parliamentary Group (APPG) Chair Mark Pawsey, MP, who has called into question why the U.K. government is continuing to fund the body to the tune of £340 million ($471.8 million) over the next four years.

    The UKVIA notes that this action flies in the face of the scientific reality of vaping in the U.K., which has seen millions of people quit smoking in recent years. Research by British scientists has consistently shown vaping to be the most popular and successful aide to quitting smoking.

    The Cochrane Review into e-cigarettes highlights that existing studies show that vaping is nearly 50 percent more effective in helping smokers quit cigarettes than other methods of smoking cessation, according to the UKVIA. The review found that as many as 11 percent of smokers using a nicotine e‐cigarette to stop smoking might successfully stop compared to only 6 percent of smokers using nicotine‐replacement therapy or nicotine‐free e‐cigarettes or 4 percent of people having no support or behavioral support only.

    The vaping industry here in the U.K., together with the All-Party Parliamentary Group for Vaping, is right to call out these baseless attacks on the sector.

    There are already 3.2 million adults in Great Britain who have made the switch from smoking. The vaping industry needs to be supported as a British success and able to assist the remaining 6.9 million adult smokers in the U.K., according to the UKVIA.

    “The stance of the World Health Organization is extremely concerning,” said John Dunne, UKVIA director general, in a statement. “The vaping industry here in the U.K., together with the All-Party Parliamentary Group for Vaping, is right to call out these baseless attacks on the sector. Vaping is a great British success story, enabling millions of people to switch from smoking.

    “The APPG is also right to call for the U.K. government to reconsider the level of its funding to the World Health Organization in light of these reports. Thankfully, now that the U.K. has left the EU, it is no longer bound by the ridiculous, and quite frankly dangerous, WHO messaging urging the bloc to treat vaping in the same way as smoking.”

  • Fresh Thinking

    Fresh Thinking

    Photo: Olrat

    The WHO and tobacco policy: a seven-point reform agenda

    By Clive Bates

    In the light of the global pandemic, there have been calls to abolish, repurpose or revitalize the World Health Organization. I am firmly in the revitalize camp. Naturally, most of the hindsight has focused on the WHO’s response to infectious diseases. In April 2021, Covid-19 deaths are approaching 3 million worldwide. However, according to the WHO, tobacco-related deaths exceed 8 million annually. So what would new thinking on the WHO’s approach to tobacco policy look like? Here is my seven-point reform plan.

    1. Commit to the goals that make a real difference

    The WHO is the lead agency for Sustainable Development Goal (SDG) 3—“Ensure healthy lives and promote well-being for all at all ages.” This broad goal is broken down into 13 targets, and SDG 3.4 is the target that really matters in tobacco policy:

    “By 2030, reduce by one-third premature mortality from noncommunicable diseases through prevention and treatment and promote mental health and well-being [compared to 2015].”

    This target should become the mission statement for the WHO’s work on tobacco. The WHO should have a laser focus on addressing severe disease—dying in agony of cancer, dropping dead with a heart attack, living in misery with emphysema—reducing real harms as far as possible as quickly as possible. It should not be distracted by dreams of a tobacco-free or nicotine-free society. It is possible to achieve radical reductions in disease burden by switching nicotine use from high-risk combustible tobacco products to low-risk smoke-free tobacco and nicotine products. This is the harm reduction strategy, and it provides a fast-acting way to reduce the drivers of disease among those most immediately at risk.

    2. Embrace innovation in the tobacco and nicotine market

    In theory, the WHO is open to innovation, and it recognizes that: 

    “Health innovation identifies new or improved health policies, systems, products and technologies, and services and delivery methods that improve people’s health and well-being. Health innovation responds to unmet public health needs by creating new ways of thinking and working with a focus on the needs of vulnerable populations.”

    This is a reasonable description of innovation in the technology and business models in the tobacco and nicotine market since 2007. No organization should be suckered by every new idea. Still, there is a pressing duty of curiosity and a moral obligation to see how innovations can be made to work for the greater good. Sadly, the WHO has been an enemy of innovation in this field, displaying indifference to significant opportunities while uncritically embracing prohibitionist or abstinence-only talking points and pseudoscience.

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    3. Implement harm reduction in the Framework Convention on Tobacco Control

    If a reimagined WHO focuses on addressing the drivers of disease and embraces innovation, it follows that a rethink of the design of the Framework Convention on Tobacco Control is necessary. Fortunately, Article 1d of the FCTC defines tobacco control to include harm reduction:

    “(d) ‘tobacco control’ means a range of supply, demand and harm reduction strategies that aim to improve the health of a population by eliminating or reducing their consumption of tobacco products and exposure to tobacco smoke.”

    But making this concept operational means more than trivial tinkering. It means restructuring the treaty to be “risk proportionate.” That means taking a differentiated approach to different tobacco and nicotine products according to risk. The idea is to discourage the use of high-risk products while promoting migration to low-risk products. For example, taxes on cigarettes would be high but low or zero on vaping or heated-tobacco products. Advertising of cigarettes would be prohibited, but the promotion of low-risk products would be permitted but subject to controls on themes, placement and media type. Warnings would be stark, bold and pictorial on smoking products but would be more nuanced risk communication messages on smoke-free products, positioning them as lower risk than smoking but not risk free.

    There is more to harm reduction than switching to reduced-risk products. A broad approach would address the whole spectrum of harms experienced by nicotine users. That includes harms induced by tobacco policy, including regressive taxes, stigma and intrusions into consumers’ autonomy to manage their own risks at their own expense and on their own initiative.

    4. Take a more sophisticated approach to policy appraisal

    Tobacco policymakers must make a realistic assessment of the impacts of their proposals, including the potential perverse consequences. The Royal College of Physicians captured the dangers very well in its 2016 report “Nicotine without smoke: Tobacco harm reduction”:

    “However, if [a risk-averse, precautionary] approach also makes e-cigarettes less easily accessible, less palatable or acceptable, more expensive, less consumer-friendly or pharmacologically less effective, or inhibits innovation and development of new and improved products, then it causes harm by perpetuating smoking.”

    This quite simple idea has yet to gain traction at the WHO. In January 2021, the WHO presented the findings of its expert panel on tobacco regulation to the WHO executive board. Recommendations include banning open vaping systems, banning all promotion of vaping products and treating heated-tobacco products like cigarettes in regulatory and fiscal terms. There is no sign that anyone involved considered how this could all go wrong and amount to regulatory protection of the cigarette trade, encourage smoking and cause more harm.

    A revitalized WHO would become the global expert on both the intended and unintended consequences of tobacco policy and be respected for the quality of its policy analysis and guidance on impact assessment.

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    5. End the drive for prohibition

    Outright prohibitions of low-risk products are a special case of bad policymaking. Through papers for the FCTC Conference of the Parties (for example, FCTC/COP/8/10) or decisions by the COP (for example, FCTC/COP8(22)), the WHO has used its influence to advocate prohibitions of low-risk products. The WHO’s prohibition reflex continues despite decades of evidence that nearly all prohibitions do more harm than good. Take the poster child of tobacco prohibition, the outright ban on tobacco in the Kingdom of Bhutan. Even the WHO has had to acknowledge it has been a dismal failure.

    “Despite efforts on the part of relevant authorities, a tobacco black market, as initially feared, has emerged. Shops that thrive on illicit sale of tobacco and its products have found a way around the law. A steady stream of loyal customers continues to sustain these shops that have, over the years, grown into a network of black market. Recent studies have found Bhutanese youth, who are among the highest in the region to be using tobacco and its products, to be at the center of this burgeoning contraband good. (WHO Country Office for Bhutan 2020.)”

    But that policy failure is compounded when the prohibition applies to much less risky products than the ubiquitously available market incumbent, cigarettes. Why would a health organization applaud India’s government for prohibiting e-cigarettes when India has around 100 million smokers? But the WHO celebrated with a tweet congratulating the country on its ban.

    A revitalized WHO would not be a cheerleader for prohibition. It would play a dignified and diplomatic role, quietly counseling its members against policies that have known and obvious negative consequences.

    6. Rethink the stakeholder landscape

    Some critical stakeholders have been almost entirely excluded from the deliberations of the WHO and the FCTC. This has usually been justified on the spurious basis that they may be acting as agents of the tobacco industry. The most obvious omission is the consumer groups that represent the populations at risk and those likely to be directly affected by policies promoted by the WHO. They can rightly assert “nothing about us, without us” and refer to the inclusive philosophy of the Ottawa Charter on Health Promotion, yet they have no voice and are often treated with contempt.

    The U.N. Framework Convention on Climate Change (UNFCCC) takes a more enlightened approach to stakeholders than the WHO FCTC. The FCTC restricts participation to international groups vetted and approved by the secretariat. It does not allow critical perspectives into its meetings. The UNFCCC, by contrast, welcomes anyone professionally engaged in the field, including climate change sceptics, the automotive trade and the coal industry, to register as observers even though their interests are not necessarily aligned with the objectives of the treaty.

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    7. Show some leadership

    The FCTC was finalized in 2003, and it predates much of the innovation that underpins the harm reduction opportunity. But the problem is not merely with the text, which is a product of its time, but the culture of hostility to these innovations. Bad science and poor policymaking are pervasive in the WHO, the convention secretariat and among many delegates and advisers to the FCTC. The culture is further distorted by the flood of money from American philanthropic foundations with a prohibitionist agenda directly funding the WHO and many of the “civil society” groups that engage with the WHO. This culture will not change without a thorough reassessment at the highest leadership level or, if necessary, revitalized leadership. Too many lives are at stake to allow neglect and negligence at the WHO to deny hundreds of millions of people the opportunities of tobacco harm reduction.

  • THR Groups Worried About ENDS Advice

    THR Groups Worried About ENDS Advice

    Photo: Vaperesso

    Vapor advocates have expressed concern about recent recommendations made by the World Health Organization (WHO) study group on Tobacco Product Regulations to prohibit electronic nicotine and non-nicotine delivery systems where the user can control device features and liquid ingredients. The WHO has also called for a ban on vaping systems that have a higher “abuse liability” than conventional cigarettes, for example by controlling the emission rate or flux of nicotine.

    Clive Bates

    Clive Bates, a tobacco harm expert and former director of Action on Smoking and Health (ASH), called the advice irresponsible and bizarre. “If governments take it seriously, they will be protecting the cigarette trade, encouraging smoking and adding to a huge toll of cancer, heart and lung disease,” he said.

    The U.K. Vaping Industry Association (UKVIA) said the WHO is out of touch with growing evidence on the public health potential of vaping. “Certain WHO positions are now so out of date, and so thoroughly refuted by the experts, that they may as well be saying the earth is flat,” said John Dunne, director general at the UKVIA, in a statement. “They deviate dramatically from leading experts, including Public Health England and Action on Smoking and Health.”

    Dunne cited the WHO’s assertion that there is “little evidence” for vaping’s role in helping people quit smoking. As early as 2019, clinical trials were finding vaping to be almost twice as effective as nicotine-replacement therapy, he noted.

    This month, Public Health England (PHE) found in its Vaping Evidence Review 2021 that smoking quit rates involving a vaping product were higher than with any other method in every single English region.

    John Dunne

    “For the WHO to hold such contrary views is either bad science or bad faith. Both risk it becoming an enemy of harm reduction,” said Dunne.

    “Vaping’s success as an industry, and its potential for public health improvements, is built on empowering personal choice,” he added. “Different systems, styles and flavors give consumers the options they need to leave combustible cigarettes behind. I would urge the WHO to engage with vapers, to hear their stories and discover the life-changing decisions they’ve made in their lives. Prohibition is simply not the answer.”

    The WHO is scheduled to hold a summit on vaping, during the Conference of Parties to the WHO Framework Convention on Tobacco Control (COP9) in The Hague in November 2021. Following its exit from the European Union, the U.K. will send a national delegation to the meeting. The UKVIA was among expert guests invited by the All-Party Parliamentary Group for Vaping to advise on the COP9 delegation’s approach.

    “The U.K. has a genuine opportunity to promote harm reduction as a valid, progressive strategy for public health on the world stage,” said Dunne. “We must not allow misinformation to undermine this potential, irrespective of the source.”