THE World Health Organization’s contempt of tobacco harm reduction (THR) jeopardizes the chance of more than a billion smokers globally to switch to less harmful alternatives like heated tobacco and vape products, public health advocates and experts said in a recent global forum.

Public health advocates who attended the 10th annual Global Forum on Nicotine (GFN23) in Warsaw, Poland said the WHO continues to ignore scientific evidence and refuses to acknowledge the merits of THR and the innovation achieved in the nicotine industry that led to the introduction of smoke-free alternatives in the market.

They noted that despite decades of international tobacco control activity spearheaded by the WHO under the Framework Convention on Tobacco Control (FCTC), more than a billion people, most of whom live in low- and middle-income countries, continue to smoke, and seven million of them die of smoking-related diseases annually.

THR is a public health approach which encourages smokers who do not quit to switch to less harmful nicotine products such as e-cigarettes, heated tobacco, nicotine pouch and other smoke-free alternatives to significantly reduce the impact of smoking cigarettes on their health. Scientific studies show that it is the smoke, and not nicotine, that causes serious diseases and even premature deaths among smokers. This is because when tobacco burns, people inhale smoke which contains thousands of harmful and potentially harmful chemicals.

Dr. Alex Wodak, a retired physician and former president of the Australian Drug Law Reform Foundation, said: “To paraphrase Michael Russell, ‘people smoke for the nicotine, but they die from the hostility to harm reduction’.” Russell was a pioneering British psychiatrist acknowledged as the ‘father’ of tobacco harm reduction. He wrote in the British Medical Journal in 1976 that “people smoke for nicotine, but they die from the tar”.

Dr. Lorenzo Mata, president of Quit For Good, a non-profit organization promoting harm reduction to mitigate the damage caused by cigarettes in the Philippines, said: “I have been a doctor for over 40 years, and I know how difficult it is for smokers when they have no alternatives that are less harmful. They get stuck with the deadliest product in the market.”

“It is absolutely clear that consumers all around the world are demanding reduced-risk products,” said Dr. Sud Patwardhan, co-founder of the Centre for Health Research and Education which addresses the needs of the most disadvantaged tobacco users.

Le Dinh Phuong, an intensive care and internal medicine doctor from Vietnam, underscored the importance of alternative products. “I have read a lot of research, a lot of studies, a lot of medical papers showing a large evidence base that heated tobacco products can reduce the risk of COPD and cardiovascular disease. That’s why, as a physician and an educator, I have been spreading awareness about them among young doctors, among my colleagues and among my patients,” he said.

The GFN delegates, including people who have quit smoking by switching to smoke-free nicotine products, aired this concern as the WHO makes preparations for the 10th session of the Conference of the Parties (COP) to the WHO FCTC in Panama City on November 20 to 25, 2023.

Experts expressed concern about the FCTC’s push for a ban on vapes and other smoke-free alternatives, which would deprive smokers of the most effective means to quit smoking.

Dr. Colin Mendelsohn, a medical practitioner, academic and researcher in smoking cessation and tobacco harm reduction in Australia, said bans simply don’t work.

“We all know that bans and prohibitions and harsh restrictions don’t work. We have a huge black market and criminal gangs, and huge issues with enforcement and youth vaping – how much more information do we need to be clear that this is the wrong approach? We’re all aware of it, but unfortunately, closed-off political leaders are unwilling to open the door to that information,” he said.

“Many of us who have switched from smoking to safer nicotine products are deeply concerned about the decisions that may be taken at COP10 this November. Prohibition or over-regulation of safer nicotine products just push people back to combustible cigarettes, or to black market products that are potentially harmful,” said GFN program director Jessica Harding.

“Despite the direct impacts on our lives and health, the WHO bars consumer advocacy organizations from attending or speaking at COP meetings, which are shrouded in secrecy,” she added.