During this year’s Global Forum on Nicotine (GFN) which took place on June 16th to 18th, 2022, the World Health Organization (WHO) was regularly mentioned even though it was not part of the conference. And for good reason, as the international organization is one of the most tenacious and powerful opponents to new nicotine products.
Professor David Sweanor is Chair of the Advisory board of the Center of Health Law, Policy & Ethics at the University of Ottawa. He has been actively involved in tobacco and health policy issues since the 1980s. For him, the WHO contradicts its very core values:
“It’s not just about public health and how it interacts with the law. Public health comes down to basic things like trying to understand people’s lived experience, meeting them where they are and empowering them to make decisions about their own health – the very things the World Health Organization has in its charter from 1946.”
The WHO sustains that its main concern with these nicotine alternatives to cigarettes are that they are not risk-free and may be too risky, due to their appealing nature to the youth. In a report published in 2020, the organization stated:
“While cigarettes remain the most used form of tobacco products, there is a concerning trend emerging from the use of electronic cigarettes (or e-cigarettes). According to the latest available data, young people are turning to these products at an alarming rate. The new report reveals that in some countries the rates of e-cigarette use among adolescents were much higher than those for conventional cigarettes. In Poland, for example, 15.3% of students smoked cigarettes and 23.4% used electronic cigarettes in 2016.”
Numerous organizations make a stand with the WHO such as the European Respiratory Society which is an organization of “physicians, health professionals, scientists and other experts working in respiratory medicine”:
"The introduction and vigorous marketing of new devices is very tempting to smokers who want to stop smoking and mistakenly believe they can switch to another harmless tobacco product. It is also opening another avenue for attracting young people to use and become addicted to nicotine. This study adds to evidence that these new devices are not the safe substitute to cigarette smoking they are promoted to be.", said Professor Charlotta Pisinger, Chair of the European Respiratory Society's Tobacco Control Committee on their website.
Lindsey Stroud is Director of Taxpayers Protection Alliance’s Consumer Center in the United States aiming at providing data and analysis to inform and assist policymakers when addressing consumer products. In her point of view, the opponents of new nicotine products such as the WHO demonize nicotine which is adding confusion and delaying public health progress:
“ Nicotine is addictive but is the least harmful thing in a cigarette. It’s all the other chemicals that are killing people. This is demonization of nicotine… they say: “this is why e-cigarette is harmful” and it’s getting more confusing to the public when it’s actually tar and combustion”.
While the WHO and some NGOs are accusing the tobacco industry of targeting the young people with appealing products and defend their position with large campaigns saying that vaping and smoking cigarettes are the same, the tobacco industry, on the other side, is multiplying its efforts to prove that they are not.
Some have adopted a new vision (British American Tobacco goes with “A Better Tomorrow”, - Philip Morris International with a “Smoke-Free Future”) and have spent billions of dollars in Research and Development to have a seat at the table, just like other public health stakeholders. For them, “the WHO must embrace tobacco harm reduction as part of its global tobacco control response by supporting the use of safer nicotine products to quit smoking” in the words of David Sweanor. And for Tommaso Di Giovanni, Vice-President of Global Communications at Philip Morris International, the controversy is not based on science but on ideology:
“We are aware of the remaining skepticism around the industry. However, this skepticism is based on past controversies. We need to stop thinking about tobacco and health in ideological terms and always thinking about the past. We are in 2022, science and technology have made tremendous progress and today, it’s possible to offer smokers products that are less toxic than cigarettes. I can’t talk on behalf of the industry, but Philip Morris International, my company, for more than ten years now, has done everything in its power to use this scientific and technological progress ambitioning to replace, as soon as possible, cigarettes with less toxic products for those who smoke and for public health.”
Clive Bates former Director of Action on Smoking and Health in the UK, now Director of the Counterfactual, a consulting advocacy practice focused on a pragmatic approach to sustainability and public health. He is considered to be a leading figure of tobacco harm reduction. From his point of view, history between the tobacco industry and the WHO prevents substantial progress because of “irrevocable differences between the interests of the industry and public health have led them to oppose harm reduction, proposing prohibition or quasi prohibition of safer nicotine products even though WHO claims to be neutral.”
The opposition may in fact be hard to erase with so many tenacious protagonists on both sides, and different interests:
“ There is a resurgence of pride in the organization we work for. The “Better Tomorrow” destination is an opportunity to see that we can contribute positively to society. And that as a rally call has thought to have one common purpose that we think is good. We no longer feel defensive. We will speak up. And we are rather proud of what we are doing. We just need a lot more people to see it.”, said Flora Okereke during a GFN panel titled “The tobacco industry transformation: myth or reality”.
The WHO recently released a report in May “Tobacco: Poisoning our planet” affirming that “products like cigarettes, smokeless tobacco and e-cigarettes also add to the build-up of plastic pollution”. The war against the tobacco industry and the WHO seems to have a long road ahead unlike millions of smokers worldwide.
