Why go around the world to defend e-cigarettes?

Freelance journalist John Lund took the pulse of Vejpkollen's editor and founder Stefan Mathisson after his trip to Panama and the WHO Tobacco Convention in February 2024. What really happened down there, how does it affect Sweden and why do people travel around the world to get involved in something as strange as e-cigarettes?

Travelling halfway around the world to engage with a... product? Vejpkollen's editor-in-chief and founder Stefan Mathisson embarked on the long flight from Gothenburg to Panama City for a week of activity and anti-activity, centred around nicotine products and the fight to save them, or destroy them. At the centre was WHO COP10 meeting on tobacco controllwhich took place on 5-10 February this year, but also an alternative conference, called "Good COP". 

Situation before Panama

The World Health Organisation's COP10 meeting, or 'Conference of the Parties to the WHO Framework Convention on Tobacco Control', did not attract much media attention. But there were many items on the agenda, not least the issue of 'new nicotine products' - which the WHO wants to equate with regular cigarettes and other combustible tobacco. Among other things banning flavours, banning open systems, develop a universal standard model of e-cigarette with a mechanism that shuts down after a certain number of puffs, redefine vapour from e-cigarettes as tobacco smoke, tax new nicotine products on par with regular cigarettes, define anyone who vejps or snuffs as a smoker who has failed to quit and, finally, ban everything and aim for a "nicotine-free" world. 

An alternative conference

"Tobacco harm reduction" is not on the map - that phrase is considered to be invented by the tobacco industry, "Big Tobacco", to "lure future generations into a lifelong addiction". No dissenters are welcome to join, so the prevailing agenda is pretty much unchallenged. In contrast, and in parallel with COP10, the US organisation Taxpayers Protection Alliance (TPA) organised a 'counter-conference', sometimes called the 'Good COP', with panels where everyone was welcome to participate: experts, users, activists and others. Stefan Mathisson, editor and reporter at Vejpkollen, was one of the participants.

Did you have a packed schedule?

"There was hardly any time to see the country itself, you could say. On the other hand, the Panama Canal is a bit like a harbour in Gothenburg, but a bit bigger of course. And it's 40 degrees instead of a mere two in February."

Was it the TPA programme that you followed?

"They had a programme and many people I have met at other conferences. I followed their programme and attended the panels, but I want to see as many sides as possible. That's the goal I have with Vejpkollen, to try to unravel what this discussion is about and to try to show as clearly as possible who is involved in this debate about e-cigarettes and snus and nicotine and harm minimisation and what interests exist and that everything is not black and white, and to talk to as many people as possible - otherwise it would have been quite boring to go. So the first thing I did was go to the conference centre where COP10 was taking place. There, I ran into various activists, anti-tobacco and anti-vape people who I tried to talk to, but they didn't want to talk to anyone who wasn't inside the actual venue, where only the authorised people were allowed. But they filmed us, the journalists who were outside."

Did they film you to document various "suspicious" individuals?

"I think so, actually. These groups work a bit like that. The anti-tobacco movements are a story in themselves. It's pure war. The Antifa movement and the right-wing extremist groups work in exactly the same way, I have observed. Very harsh and very threatening. This gang was quite old, but they behaved more like children. It came from Mexico in particular, a fairly large group with placards saying "Stop Big Tobacco and "Ban vaping" and pictures of crossed out e-cigarettes. It was interesting to see up close. And while this group was having their demonstration, there was also a group of tobacco farmers counter-demonstrating and also cigar manufacturers, both of whom believe that their activities do not belong in the tobacco convention because they have nothing to do with cigarettes. They were not allowed into the conference either. And then there was a Spanish vape and harm reduction activist, Julio Ruadeswho I interviewed, who actually managed to get into the entrance hall. His YouTube channel has half a million followers. Pretty soon he had to leave again, escorted by guards. I was also interested in the situation in Panama itself, their regulations and so on. Panama has banned the sale of all e-cigarettes and also increased taxes on cigarettes. Anyway, it was very easy to get e-cigarettes. I talked to people from the local vape organisation, who have filed a lawsuit against the government because they think this ban is unconstitutional. 

Then I went and listened to most of the programmes. "The 'Good COP' panels, which took place every evening, and got hold of different participants with whom I also conducted interviews."

Were there many travelling journalists?

"Quite a few, who like me had come to see what it was all about. Many knew very little or nothing about what e-cigarettes really are or the difference between smoking and vejpa, or even snus or nicotine pouches. It actually became a whole section of my journey, explaining to other journalists what this is really about, being both a journalist and an activist at the same time."

It is remarkable to have been given this assignment, while lacking the most basic knowledge, one might think?

"You might think so. But it is frighteningly common. Even in Sweden. I am not surprised. The media coverage of e-cigarettes and harm minimisation is very poor in the mainstream media and beyond criticism."

Did you watch any of the streamed broadcasts of the COP10 meeting and what were your impressions?

"I did. The first session was supposed to be broadcast live, but there was some technical difficulties so they only put a small part of it online. But the "Good COP" people managed to get the whole session in the end and got it online pretty much immediately. It was interesting to see the different nations' statements on tobacco and nicotine. There was some really angry rhetoric from The Netherlands, which wants to ban virtually everything related to alternative nicotine products. China The country has been praised for its efforts to reduce smoking, while state-owned tobacco companies account for half of all tobacco sold in the world - and the country is also the world's largest producer of vejp products. 

What was the atmosphere at the meeting?

Let's not forget that the WHO has been taking a very aggressive, negative approach to e-cigarettes for some years now. They advocate a ban, preferably a total ban; they say that it is not possible to stop using e-cigarettes because there is no evidence. There is a very aggressive atmosphere. 

What did the different delegates say about harm reduction and vejping?

Of course, I was particularly curious about Stor Britain, New Zealand and Philippineswhich all have quite progressive legislation on alternative nicotine products and what they would say, or dare to say. And what Sweden would say, if they were to make any particular statement? But they chose not to. Instead, they let the EU make a joint statement."

It seems rather remarkable to avoid making any statement at all, in light of the international attention Sweden is currently receiving - including among established scientists - because of its low smoking rate and the availability of snus - and the fact that these two factors influence each other. There is talk of a country where harm minimisation actually works, and is encouraged by the system. "The Swedish Experience" is an expression that may be becoming as famous as "The Swedish Model" was in the 20th century, with its middle ground between socialism and capitalism. Snus has been talked about more than ever in the last ten years, it seems. Sweden should almost have felt compelled to make some kind of statement on the matter - especially in these times.

"You might think so. But much of this discussion is completely untouchable - because Swedish snus, with its presence in a country with very low smoking and smoking-related disease statistics, is sold by a tobacco company. Swedish Match. It is now also, in fact, Swedish Match that has coined the expression "The Swedish Experience". Therefore, such a discussion is completely unsustainable in the WHO context, when the link with a tobacco company is so clear. I personally believe that it would not be possible to stand up and say anything about it at all. At the same time, it is true that the proportion of smokers in Sweden is very low, statistically speaking, but that smokeless tobacco and nicotine have increased. The link is clear. And the Swedes could actually point this out. It's also worth mentioning that we have fairly strict laws on tobacco and nicotine across the board, but we allow everything on the market and let individual companies control what sales look like in the shops. And you'd think that the Swedish delegation would talk about this, but at least I didn't expect them to actually do so. Instead, it should be the politicians' job to speak for the Swedish model in this area."

How do you explain to others how things work in Sweden?

"I was recently visited by a Brazilian harm minimisation activist from Brazil, who had come to Sweden to see how we were doing and what it looked like, this with "The Swedish Experience". "Who should I talk to?" she asked. "I know something even better than talking", I said, and took her to the first press agency and looked at their display of nicotine products. In Sweden, you hardly see cigarettes anymore. Instead you see snus, and more and more lately, e-cigarettes. Somewhere it manifests a desire on the part of the store that they simply don't want to sell cigarettes anymore."

Moreover, not based on political decisions, but on reason and the principle of natural selection. To the annoyance of those who insist on political interference in time and even untimely, possibly. Did you have contact with any of the travelling members of the Swedish delegation, either during the conference or before, back home in Sweden?

"I did. I found out who was involved and did an interview with the head of the delegation, Paula Ericson, who is an expert at the Ministry of Social Affairs. She was very quiet and would not and cannot say anything about anything. Sweden would hold the EU's positionwas the message. I asked for the documents that existed, and when I received them, most of them were crossed out with black secrecy markings. On the other hand, I spoke to many politicians before the trip, and today you love to talk about harm minimisationat least on the right, where this model has been adopted as a political force. They have realised that snus and smokeless nicotine are important to people. Even the Social Democrats, who last year were very prohibitionist at home, have come out in favour of snus and nicotine pouches in the EU. So politicians are happy to talk, while officials are more reticent."

Then there is the lobby against nicotine, both in smoked tobacco and in all other forms. It is sometimes said that Sweden has endorsed the World Health Organisation's Convention on Tobacco Control and should therefore introduce the rules applicable to this Convention. This can sometimes sound almost binding or coercive, but is it really?

"For example Public health authorities is very careful to point this out, yes. It is a recurring bat to convince politicians to do what they think is right - and also to keep relevance and funding - but one should never forget that it is a recommendation, even if it looks bad not to follow it. Perhaps not so much for a country like Sweden, compared to a country without a clear profile in regulation. Harm minimisation is actually included in WHO trainees as a possible tool, that should not be forgotten, after all."

It sounds a bit like a church, that COP10 meeting, with various strict "decrees". The church had power once, but not today, at least in a modern country like Sweden. Can we take some of what has been said with a pinch of salt, at least in the real world?

"This is probably true to some extent. If you go to the national level in the respective countries, a lot depends on how knowledgeable the politicians actually are on the issue, and who is in the majority. Do not forget that it was a flavour ban on the agenda in Sweden only a year and a half ago, and even then the WHO and the Framework Convention were discussed. Some countries, such as The Netherlands and Denmark, oddly enough, two rather "liberated" countries in some areas, have both voted to ban flavours. The difference is probably that Sweden has politicians who have understood this harm minimisation and went against the grain."

So did anyone actually address harm minimisation at COP10 in Panama? Sweden did not, and the UK reportedly avoided talking about its open-minded approach to e-cigarettes, much to the disappointment of many. Was there anyone who dared to try to hammer away at the WHO's massive wall of resistance?

"New Zealand, which has halved their smoking rate since they started advocating for e-cigarettes, at least almost saying it, but avoiding the word "e-cigarettes" in favour of "evidence-based harm reduction approaches". In reality, they have been running government campaigns to get people to quit smoking using e-cigarettes. Most of all, St Kitts and Nevis, a Lilliputian country in the West Indies, took the opportunity to say that they didn't think we should just talk about bans on e-cigarettes and smokeless nicotine, but instead have a calm discussion, and that we should create a working group to talk about harm reduction. Which also seems to be happening. And which also led to the fact that there was not a single consensus decision on e-cigarettes or snus or nicotine pouches this time and that everything will be postponed until the next meeting in two years. Because of this small country. A big country would probably not get away with this, they would be too afraid to. And both St Kitts and also the Philippines, who also said positive things about harm reduction, were really put down by the anti-organisations, who were also there, and were told that they were doing the bidding of the tobacco companies. It must be remembered that the people running these activities are not health experts but opinion formers with one message: that the tobacco industry is a hole in itself. And everything they touch is pure evil. I sensed a very tense atmosphere in the room."

What do you think and feel about the future of e-cigarettes and other smokeless nicotine products?

"I actually think that something can happen within the WHO, given that many countries have actually realised that harm minimisation for smokers is not a joke. And you can actually thank the tobacco companies for lobbying on the issue of being able to sell a new product instead of cigarettes. This has created a breeding ground for us users of alternative nicotine products that no one usually listens to, but which, over time, are considered to be able to add something to the discussion. The WHO will certainly continue with its hard line and crusadeat least until the funding starts to dry up. But most importantly, we have a situation in the world, not least in Sweden, where this has become too big to fail. We have reached a kind of critical mass now, when so many people are using these products, and to suddenly start whining about bans is simply not going to work. More and more, there will be a demand for a change in attitude about these things, and when politicians hear more and more from those of us who want to get rid of cigarettes through the new products, good things will happen, I am convinced." 

Do you have any good memories of your own from the trip?

"Absolutely. Particularly nice was an observation that Bengt Hedlund did. Bengt is editor and CEO of Convenience Stores Sweden, a knowledge centre for shops, wholesalers and suppliers in Sweden, was also there, we travelled down together. When we attended TPA's panel discussions, there were a number of people I already knew from other contexts and conferences, and I was talking to an Indian doctor about some new technology and we both filled in the blanks and the conversation was in full swing. And Bengt says: 'This is fantastic. You come from completely different parts of the world. And you come together around... a product, which obviously means a lot to both of you, and which you are now travelling halfway around the world to get involved in." That's pretty strong. This is a movement. It's global. It's not going to go away. It's not paid for by the tobacco industry. This is about people."

"Another fun thing is to check out the duty-free shops and what's available and what's not. Liquor and cigarettes are always there, and perfumes. But nowadays there are some brands of e-cigarettes as well. Admittedly, these are mainly products from the big tobacco companies, but it's still exciting. Something has happened here. It would have been impossible just ten years ago. It's a great trend."

John Lund
Free lance journalist