Flavour bans, higher taxes, bans on open systems and disposable models. And strong measures to restrict access to nicotine pouches and snus. These are some of the measures that the WHO Tobacco Control Secretariat wants to see included in the next version of the FCTC.
"The WHO focuses more on e-cigarettes and nicotine pouches than on discouraging cigarette use. They don't care about protecting the alternatives that can improve smokers' health" said Lindsay Stroud, Tax Payers Alliance.
The tenth WHO meeting on tobacco convention, COP10, will take place from 5 to 10 February 2024. The conference, which was originally scheduled for November 2023, had to be cancelled due to complications in the host country Panama. The 1,500 delegates from the 190 countries that have signed the Convention had to kindly adapt and go to Panama City in February instead.
At the same time, activists and organisations from around the world will organise an alternative conference on the margins of COP10. The aim is to draw attention to harm minimisation products and alternative tools to reduce smoking in the world.
"We want to present a different picture than the one painted by the WHO. It is ultimately consumers who have changed the market for nicotine products in the world, not the measures advocated by the WHO. Tobacco companies have more or less been forced to change their offer, from selling only cigarettes to launching less harmful products like e-cigarettes and other smoke-free alternatives. This is how a free market works. Authorities supported by the WHO have been trying to do the same thing for ages without success". Says Lindsay Stroud, active in the organisation Tax Payers Alliance, an independent think tank organising the alternative conference.
Tougher approach to harm minimisation
According to the document sthat the WHO Tobacco Control Secretariat will present at the conference shows that in the future it wants more products to be included in the directives on which the Tobacco Convention is based. The official position of the WHO has long been that e-cigarettes and heat-not-burn products, but also modern nicotine pouches and Swedish snus, preferably be prohibited; or are classified as medicines. I several statements, including via X (formerly Twitter), the practice is summarily labelled "harmful" and urge the countries which have not already banned the products, to regulate them in the same way as cigarettes.
Conflict over nicotine and medicines
This has led to a conflict with some of the the countries that have signed the Tobacco Convention. Several major health organisations, such as US FDA and UK Public Health Agencyemphasises that vejpaking nicotine is significantly less dangerous than smoking. The WHO, on the other hand, states that all nicotine use by definition is harmful and should be regulated out of principle. At present, nearly 100 million people e-cigarettes, snus or nicotine pouches worldwide.
"In countries where uptake is highest, cigarette use declines faster than in countries where the products are either banned or heavily restricted." the addiction researcher recently noted Lion Shahab which led the largest study to date on how alternative nicotine products relate to smoking in the world.
Harm minimisation or drugs
The ideological clash over nicotine has created a deep conflict between, on the one hand, the WHO's Tobacco Control Secretariat, which believes that only medicines and various forms of therapy to be used in smoking cessation programmes. On the opposite page is user organisations together with company and beroving researcher which argues that a regulated market for harm minimisation products is a more humane and effective way to reducing harm of smoking.
"Refuses to look at the issue scientifically"
Lindsay Stroud believes that WHO experts have lost, or rather ignored, the scientific perspective on the tobacco issue.
"The WHO has consistently refused to recognise that different nicotine products pose different risks to the population. The US FDA is now reportedly focusing on providing more accurate information to the public about the relative risks of different forms of nicotine use. The misunderstandings among smokers about the differences in risk between vejpa and smoking are alarming. According to the risk ladder used by the FDA, cigarette smoking is by far the riskiest use, while the risks of nicotine medicines are almost non-existent. E-cigarettes are just above nicotine medicines in terms of risk. But the WHO refuses to even consider this. It's as if the scientific perspective has been completely lost", says Lindsay Stroud to media channel Regelator Watch.
"A revolution driven by consumers"
E-cigarettes were for a long time a product with a life of its own, via the small independent companies and consumer-driven trends. The technology originated in China and the market has grown. exploded in the last 20 years. It was only when e-cigarettes began in earnest that compete with cigarette sales that tobacco companies entered the market. Lindsay Stroud, who works in consumer affairs and statistics at the Tax Payers Alliance, says the development is among the most astonishing she has ever seen.
"Vaping is a consumer-driven revolution, which really has nothing to do with the tobacco companies. It has been very exciting to follow the development in recent years. The WHO says that it is the tobacco companies that "want to attract a new generation to addiction", but it is rather that those who use nicotine for various reasons started to make new demands. They eventually forced the tobacco companies to change." says Lindsay Stroud.
Taxes make states addicted to cigarettes
The problem, according to Lindsay Stroud, is that the WHO has a completely unreasonable attitude towards anything to do with tobacco companies. Under the Tobacco Convention, there is an automatic "irreconcilable conflict" between the interests of tobacco companies and public health, she says.
"Many tobacco companies want to reduce the risks of the products they sell, which is certainly in the interest of users. But the WHO doesn't care about that. Instead, it wants to limit the scope for change. Ironically, it argues in favour of taxation as an effective tool to curb both cigarette sales and other nicotine products. In many countries, high taxes have only served to make governments dependent on the huge tax revenues generated by sales. They are unlikely to be very interested in taking cigarettes off the market, it would be too expensive. " says Linsdsay Stroud.
Industry must not have influence
Neither tobacco companies, consumer organisations nor individual activists advocating harm reduction in tobacco policy are welcome to attend meetings on the Tobacco Convention. According to the WHO, this is due to an article in the Convention designed to "prevent industry influence". Lindsay Stroud thinks this reasoning is flawed from the start.
"It is as if we were to discuss solutions to the climate issue without inviting the energy companies or car manufacturers into the conversation. Are greener cars from Toyota meaningless, just because Toyota has "an interest" in selling cars?" says Lindsay Stroud.
A different view of reality
From activists to scientists and doctors, the alternative conference will highlight harm reduction as a complement to the tobacco convention's prohibition measures. All to reduce the harm caused by smoking.
"We had a good turnout for the November meeting and we hope that the interest is just as high in February" says Lindsay Stroud. "We have experts and activists from 16 countries who can respond to what comes out of COP10 directly on the ground. It is important to remember that neither consumers nor those scientists who have a different view of reality than the WHO Tobacco Control Secretariat are allowed inside the conference. Not even as listeners. This is the TPA's way of promoting a different narrative, and something we have been looking forward to doing for years" says Lindsay Stroud.