"Make smokeless nicotine products part of the strategy to improve global health. And stop protecting the cigarette trade". That's the message, from 100 scientists, health scientists and doctors, in an open letter to the WHO and participants in the upcoming tobacco control summit in November.
The war over e-cigarettes and harm reduction is escalating. Ahead of the WHO summit in November, 100 health researchers are now calling on the World Health Organization to change its approach to alternative nicotine delivery technologies.
"There is now convincing evidence that smokeless nicotine products are significantly less harmful than cigarettes. There are also clear signs that various technologies, which have emerged over the past 15 years, may displace cigarette use, not only for individuals, but also at the population level, in the near future" the 100 health scientists write.
Refers to harm reduction in other fields
The group, made up of scientists, social workers, psychologists, health workers and doctors from around the world, cites products such as e-cigarettes, Swedish snus, heat-not-burn and nicotine pouches as good examples of innovative technologies that can curb smoking worldwide.
"Harm reduction is practiced in many areas of public health, in the fight against illicit drugs, sexual health and HIV. The Framework Convention on Tobacco Control also recognizes harm reduction as a tool in tobacco policy. For hundreds of millions of people who are struggling to quit smoking, but want to continue using nicotine, these products represent another pathway away from the deadliest form of nicotine use," the group writes.
Targeted information for smokers
They refer to a number of major independent reports that summarize the benefits of harm reduction policies, compared to harsh bans and restrictions. Heavyweight institutions like British Medical Association, together with Public Health Agency of Sweden in the UK has long encouraged smokers to switch to smokeless alternatives, such as e-cigarettes. Now the 100 experts want to see a similar development in the WHO.
"Although science already shows that vejpning increases the chances of quitting smoking, a deliberate policy of informing smokers about the relative risks of harm between vejpning and smoking would hugely increase the potential of e-cigarettes. This is the opposite of what the WHO is doing today." writes the group.
Follow the science - not the tobacco companies
WHO has previously received harsh criticism for their campaigns to target e-cigarettes and other alternative nicotine products in the same way as smoking tobacco. According to the WHO's assessment, tobacco harm reduction is just a marketing ploy by tobacco companies, unsupported by research. According to the contributors, this is far from a scientific approach to the issue.
"Of course, we have to be aware that tobacco companies are also involved in the new technologies. And we should be careful. But we must also take into account the extensive scientific evidence we have today. We must not let excessive caution or uncertainty deny smokers promising alternatives that lead away from the combustible products that we know for sure are deadly." the group writes.
WHO protects the cigarette trade
They also point out that the WHO's stance and policy on the issue actually strengthens cigarette sales worldwide.
"WHO routinely advocates for outright bans on smokeless alternatives to cigarettes or the regulation and taxation of smokeless products equivalent to cigarettes. The danger of this is that it creates a regulatory shield for the cigarette trade. It causes harm by increasing, rather than decreasing, smoking," the group writes.
Calls for an independent review
The group provides the WHO, as well as countries committed to the WHO Framework Convention on Tobacco Control (FCTC), with six proposals to reduce the harm caused by tobacco smoking worldwide:
- Implement tobacco harm reduction as part of the strategy to improve global health, in particular for smokers and those at risk of becoming smokers.
- Require the WHO in its policy analysis to properly assess the benefits of alternative nicotine products for smokers or would-be smokers, including adolescents. At the same time, evaluate risks for users and non-users of these products.
- Require that all policy proposals, especially bans, take into account the risks of unintended consequences. This includes risks of increased smoking and other negative reactions.
- Apply Article 5.3 of the FCTC to address the influence of the tobacco industry. But don't let this become a barrier to products with a reduced risk profile, which bring public health benefits. Nor let it 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 companies with significant specialized expertise not found in traditional tobacco control work.
- Set up an independent review of the WHO and FCTC approach to tobacco policy in the context of the SDGs. Such a review should examine: the interpretation of available research, the quality of WHO policy advice, the influence of special interests, accountability and governance. The Independent Panel on Pandemic Preparedness and Response (IPPPR), initiated to evaluate the response to the COVID-19 pandemic, offers such a model.
Big meeting in November
The WHO has not yet commented on the petition. The letter has been sent to governments and politicians in all countries participating in the upcoming WHO meeting on the FCTC (Framework Convention on Tobacco Control), also known as COP9. Among the 100 signatories of the letter are some Nordic researchers such as Lars Ramberg of Sweden and Karl E. Lund of Norway. Several internationally known names in the tobacco control field, such as Clive Bates, Robert West, David Nutt, Ethan Nadelman and Clifford E. Douglas, have also signed the petition.
Our wimps of politicians have not understood the opportunity e-cigs offer them.
Now there is actually a perfectly good alternative, with very low levels of harm, so why don't they take the chance and ban smoking tobacco and refer to the alternative?
Talk about improving public health!