The World Health Organisation (WHO) has just published a summary document on tobacco control and harm reduction, a few days before the opening of the Conference of the Parties to the Framework Convention on Tobacco Control (FCTC COP-11), which will be held in Geneva next week.
This paper starts by saying that:
Tobacco and nicotine product companies, and associated front groups, are increasingly promoting a range of tobacco, nicotine and related products. They claim these products pose lower risks to health than conventional cigarettes and can be part of a ‘harm reduction’ approach to tobacco control.
There is a lot to say about that first paragraph:
1. Wrongly associating harm reduction proponents with industry front groups
In reality, many proponents of harm reduction are scientists who evaluate the facts neutrally and objectively and conclude that non-combustible products are less harmful than cigarettes, and that e-cigarettes help smokers quit. Labelling them as industry ‘front groups’ is an unfounded attempt to discredit them, it is an insult, and this is unworthy of an institution such as the WHO.
2. Wrongly saying that non-combustible products are as dangerous as cigarettes.
The science is very clear: the risks associated with tobacco use come mainly from burning tobacco and inhaling smoke, and non-combustible products are less harmful than combustible products. By suggesting that all products containing nicotine and tobacco are equally harmful, the WHO is promoting misinformation and discrediting itself.
3. Always using quote for ‘harm reduction’ and presenting it as a tobacco industry ploy
The WHO and the FCTC Secretariat now routinely use quotation marks around the term ‘harm reduction,’ implying that harm reduction does not exist or is a ploy of the tobacco industry. They refuse to acknowledge that harm reduction is mentioned in the FCTC itself :
FCTC article 1 (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
The WHO position document also says:
All tobacco, nicotine and related products pose health risks, including risk of addiction (4). Wide variation in product characteristics (including within product categories), and how products can be manipulated and used by consumers, limit our ability to generalize about the health risks posed by entire product categories.
The problem with this statement is not that it is factually incorrect, but that it is misleading, as it does not tell the whole story and leads the reader to believe that all products are equally addictive and toxic. In reality, there is already sufficient scientific knowledge to assert that some products are more addictive than others (for example, nicotine patches are not addictive, and the addictiveness of a product depends on the speed at which nicotine is delivered to the arterial bloodstream and the brain), and also to assert that non-combustible products are less toxic than cigarettes. This statement and other similar statements in this document therefore constitute misinformation on the part of the WHO, which, once again, is unworthy of the WHO.
The promotion of prohibition:
The WHO document continues by recommending that :
Where countries ban manufacturing, distribution and sale of specific product categories, enforcing those prohibitions rigorously against commercial actors.
This is a call for prohibition, as if the WHO had learned nothing from the disastrous effects of banning addictive products. Already, some WHO member states criminalize not only nicotine sellers but also consumers themselves, ignoring the fact that nicotine use is more prevalent among vulnerable groups (e.g., people with mental health conditions). It also ignores the fact that in countries that ban e-cigarettes (e.g. Australia, Brazil), the e-cigarette market is now in the hands of criminal groups.
In this document, the WHO also recommends numerous other measures aimed at restricting access to non-combustible products, without taking into account the fact that, in doing so, WHO is eliminating a competitor to cigarettes and thus protecting the cigarette market, thereby increasing the mortality and morbidity caused by cigarettes. This is clearly contrary to the WHO’s mission and the objectives of the FCTC, it is a betrayal of the WHO’s noble mission, and it must stop immediately. The time has come to say ‘enough is enough.’
PS: I have no conflict of interest
Simply put, harm reduction works, no matter the source. You have only to look at population data from Sweden, with near-average nicotine use compared to the EU, but fewer cigarette smokers (less than 5%), with the lowest cancer/COPD deaths in Europe (roughly half). Clearly, what they say is not true.