Nicotine pouches, e-cigarettes and snus should be regulated as strictly as cigarettes. At least if the WHO Tobacco Control Secretariat gets its way. A growing number of scientists and health professionals are now reacting to the WHO's hostile approach to harm minimisation.
"There is a high risk that excessive restrictions on harm minimisation products will lead to more smokers, rather than fewer," says Swedish tobacco researcher Lars Ramström.
Updated article: January 2024
In view of the upcoming meeting on WHO tobacco convention (cop10) at the beginning of February 2024 (postponed from November 2023), it is clear that e-cigarettes, snus and nicotine pouches will be the subject of debate at the conference. And according to many researchers and commentators, the debate has already taken a turn for the worse. The WHO's Tobacco Control Secretariat has recommended in its reports for the meeting that the products should preferably be discontinued. should be banned, or otherwise regulated as cigarettes - resulting in flavour bans, marketing bans and other restrictions.
"Several experts have warned that the WHO's scientific advice misrepresents the state of evidence on harm reduction products," writes Lars Ramström, a Swedish tobacco researcher who has published many high-profile studies on snus use in Sweden, in the an open letter to the WHO Scientific Council.
Has the opposite effect
As previously reported by Vejpkollen, the a number of researchersin recent years, invited the WHO Secretariat for tobacco control to rethink harm minimisation as a strategy to reduce the harms of nicotine consumption worldwide.
They are joined by Lars Ramström. According to him, it has even gone so far that some of the measures recommended by the WHO scientists for smoke-free nicotine products may have a negative impact on the health of the population. opposite effect when it comes to smoking.
"Significant restrictions on alternative nicotine products, such as e-cigarettes and nicotine pouches but also snus, can have unintended consequences. The risk is that smoking will increase rather than decrease. There is also concern among many researchers that the WHO's dissemination of misinformation will discourage smokers from switching to a much less risky alternative to cigarettes," writes Mr Ramström.
Research on snus and smoking cessation
Lars Ramström has spent several decades researching the role of Swedish snus in smoking cessation. He argues that snus is a likely factor behind Sweden's low smoking rate, including through a high-profile report published in NIH - National Library of Medicine 2016. According to Lars Ramström, there is now clear evidence that harm minimisation works to reduce the harms of nicotine use.
"The best example of how nicotine products not based on burnt tobacco can benefit public health comes from Sweden. Sweden has the lowest proportion of male smokers in the EU and therefore the lowest tobacco-related mortality rate," writes Mr Ramström.
A unique opportunity
Mr Ramström believes that the Parties meeting in November, even before the meeting on the future tobacco convention, should study smoking trends in different countries. They should also take into account how the availability of different nicotine alternatives affects the proportion of smokers. Apart from Sweden, he mentions New Zealand, Norway and Japan - where smoking has declined rapidly in recent years as e-cigarettes, nicotine pouches and heat-not-burn products have become popular in the respective countries.
"The meeting of world health leaders in Panama in November is a unique opportunity to evaluate the evidence with an open mind. After all, if Sweden had followed the WHO's advice twenty years ago and banned snus, the number of tobacco-related deaths in Sweden would have been much higher than they are today. At the same time, such a measure, albeit unintentionally, would probably have favoured the cigarette industry. The measures to reduce demand for cigarettes and to reduce supply, as recommended by the WHO, are valuable tools. But the fight against smoking will not be as effective without the third pillar set out in the original tobacco convention." writes Lars Ramström.
WHO warns delegates
So far, the WHO has not responded to the criticism of Lars Ramström or the other researchers who are critical of the organisation's biased approach to harm reduction. The organisation only recommends medicines as a tool for smoking cessation. In an appeal on Tobacco Convention website Instead, the Secretariat warns delegates not to allow tobacco companies to influence how the Convention formulates its objectives. According to the text of the Convention, the objectives of the tobacco industry are always in direct contrast to those of the Convention. As a result, the conference is completely closed to the public and the practice is that neither the media nor non-profit organisations representing users are allowed to cover the conference from the inside.
Bribery allegations
The secretariat managing the work is funded by Bloomberg Philanthropies - a foundation that supports various organisations - works to prevent smoking, but also various types of alternatives to cigarettes around the world. Among other things, the Foundation has been criticised for bribing authorities in low- and middle-income countries to influence legislation on e-cigarettes.
About the Tobacco Convention:
The World Health Organisation's Framework Convention on Tobacco Control (FCTC) is an international treaty. It was established in 2005 and establishes a framework of tobacco control measures to be implemented at national, regional and international level. 182 countries have signed the Convention so far and participate in the decisions related to the FCTC. Every two years, Parties meet at a conference to discuss current issues in the field of tobacco control (known as COP meetings).
Snus has made many people, including myself, stop smoking - it should instead be sold in the rest of Europe to reduce the harmful effects of smoking.
You can't even compare cigarettes with snus. Instead of focusing on nicotine, the focus should be on which products cause harm and to what extent. Cigarettes are far more dangerous than snus and should be taxed and managed accordingly. The WHO's approach is counterproductive and instead increases mortality among tobacco users.
I hope that the Swedish delegation will familiarise themselves with the real facts so that they know what they are talking about. Unfortunately, too many people are making statements without an ounce of knowledge about e-cigarettes versus regular cigarettes.