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The World Health Organization (WHO) ignores its own treaty which obliges signatories to adopt the harm reduction approach of encouraging safer nicotine products.
Staff Report
The eighth session of the Conference of the Parties (COP8), which took place October 1-6, 2018, followed the same practice as previous sessions in Delhi and Moscow, banning members of the public, media, and tobacco industry from the conference, despite the World Health Organization’s (WHO) stated “commitment to transparency”. COP8 saw over 1,200 participants, including delegations from 148 parties to the global tobacco control treaty and representatives of UN agencies, other intergovernmental organizations, and civil society.
COP8 participants are reported to have agreed to maximize transparency to protect FCTC related sessions and proceedings from the “intrusion of tobacco industry representatives and interests.” The contradictory nature, lack of awareness, and non-transparency of COP8 participants boggles the mind.
“More than ever, we need to stay the course and strengthen our commitment to ensure that FCTC efforts to protect and promote public health and sustainable development are not hijacked by the tobacco industry,” said Vera Luiza da Costa e Silva, head of the Framework Convention for Tobacco Control (FCTC) secretariat. “We must yield no ground to the tobacco industry.”
Not all reasoning is lost
A clear example of the low level of transparency involved in COP8 lies in how the conference opened with a motion to throw the public and media out of the conference venue. The motion was supported by the majority of delegates, with only Canada opposing the motion. Canada was also the only one to dissent against a vote to throw out a previous pledge to live-stream the proceedings, suggesting a three-minute delay instead.
Despite COP8 taking place in Geneva, Switzerland has faced criticism from WHO for not endorsing FCTC.
“I think this is more of a shame than a problem that Switzerland is not party to the treaty, as this is all about protecting the public health of the population,” said da Costa e Silva. Switzerland is one of the 13 countries that have not endorsed FCTC, partly due to regulations related to advertising. Some of the other countries such as US, Argentina, Malawi, and Cuba, are thought to have rejected the treaty because they tend to be the main tobacco growers.
Voice of the people
As COP8 ended, Japan Tobacco International (JTI) published findings of a new research commissioned by JTI and conducted in Europe by Populus with Ipsos as fieldwork providers, revealing that the public want regulators to be open to dialogue with business, and that more fairness and credible evidence is needed in policy-making. The research found that of the 8,473 respondents surveyed across 8 European countries, an average of 72% believed that it is either very important or somewhat important that the policy-making process is open to dialogue between governmental authorities and all parties who are potentially impacted by it, including businesses; 79% believed that it is either very important or somewhat important that a policy should be introduced based on credible evidence of its effectiveness, instead of a biased assumption it will work; and 76% would protect the principle of free speech; either actively fighting for the right of someone they disagree with to speak, or passively agreeing with the right of someone they disagree with to express their opinion.
Another new strategy
Global reduction of tobacco use was at the top of the COP8 agenda, along with a focus on new tobacco products (NTP). Delegates also debated how to provide economically sustainable alternatives to tobacco farmers and establish an international system to track and trace tobacco.
Coming out of COP8, on October 6, WHO unveiled a new global strategy to scale up the tobacco control agenda over the next few years and to “prevent further interference by tobacco industry” in public health policies.
The strategy, called the medium-term strategic framework (MTSF), aims to strengthen implementation of FCTC with a roadmap to guide the work of the convention parties, the secretariat, and other stakeholders with regards to tobacco control from 2019 to 2025. MTSF strategy requires parties to the treaty to protect national public health policies “from commercial and other vested interests of the tobacco industry.”
In addition to tighter control actions, the parties also addressed what was defined as “the need for tobacco control efforts to integrate strategies to combat the impacts of tobacco on the environment and sustainable development.”
Industry position
In its position paper on its views surrounding COP8, Philip Morris International (PMI) urged WHO, delegates attending the conference, and the wider public health community to embrace the potential of innovative alternatives to cigarettes in order to achieve the UN’s sustainable development goals for non-communicable diseases as quickly as possible.
“The landscape of tobacco and nicotine products has evolved significantly over recent years. Not all tobacco products are the same with respect to their health risks. Moreover, rapid innovation offers opportunities to accelerate the downward trajectory of smoking prevalence,” the company said. In the paper, the company also said that ultimately, PMI aims to stop selling cigarettes entirely and is confident that this can happen in less than a century if smokers who would otherwise continue to smoke are proactively encouraged to switch to less harmful alternatives, which already exist but are either not well known or in some cases restricted.
According to PMI, the countries where these products have been adopted, such as Japan and the UK, have seen unprecedented declines in cigarette sales. Progress in these countries signals the potential for great change across the globe and is the core reason why PMI has publicly committed its future to being smoke-free, and continues to develop new science-based technologies and innovations that offer better alternatives to men and women who would otherwise continue to smoke.
PMI’s policy-making recommendations contained in the position paper include:
- Policies must continue to dissuade minors, ex-smokers, and non-smokers from using tobacco- and nicotine-containing products, while making better alternatives to cigarettes available to adults who smoke.
- Tobacco control policies should encompass tobacco-harm reduction strategies as well as supply and demand measures that encourage smokers who would otherwise continue to smoke to switch to better alternatives.
- There should be thorough, independent verification of manufacturers’ products and science to assess how ENDS [electronic nicotine delivery systems], and novel and emerging tobacco and nicotine products can support policies to reduce smoking prevalence.
- There should be national and global surveillance systems to study market trends. This surveillance should include data on product usage, including switching rates associated with different tobacco and nicotine products, to enable accurate reporting of smoking prevalence and the use of ENDS and novel and emerging tobacco products.
- Incentives should encourage investment and continuous research and development of less harmful alternatives, including the establishment of quality and performance standards for smoke-free products.
- Mechanisms should be established to enable transparent interaction and consultation between governments and producers of emerging tobacco and nicotine products.
Authors of a new report titled “No Fire, No Smoke” pointed out that safer alternatives such as e-cigarettes, heat-not-burn devices, and Swedish snus have been hugely successful at reducing smoking rates, yet WHO continues to reject all the data supporting this and maintain a forbidding stance.
“WHO ignores its own treaty which obliges signatories to adopt the harm reduction approach of encouraging safer nicotine products,” said Professor Gerry Stimson of Knowledge Action Change, London, who commissioned the report. “This is a tragic missed opportunity to stop one billion lives being claimed by smoking this century.” Knowledge Action Change is a company dedicated to the promotion of harm reduction to improve health and funded through a grant from the Foundation for a Smoke-Free World.
The report lists the 39 countries where e-cigarettes or nicotine e-liquids are banned, including Australia and Saudi Arabia as well as refers to the contrastingly positive data from countries that have endorsed safer alternatives, such as Norway, where, following the introduction of snus, the smoking rate amongst young women dropped from 30% to just 1%.
Another example is Sweden, where smoking rates have dropped to the lowest in Europe, and thanks to endorsing e-cigarettes, the UK is now boasting the lowest smoking rates ever recorded, and the second lowest in Europe.
Harry Shapiro, the lead author of the report, said, “In examining the data it has been striking how closely tied the availability of these substitutes is to plunging smoking rates. Whatever the motivation for countries banning them they need to realize that such policies make them the tobacco industry’s best friends.”
New Nicotine Alliance (NNA) chair, Sarah Jakes, urged UK delegates at COP8 to raise awareness about the significant drop in smoking rates that the country is witnessing since it has endorsed e-cigarettes and other alternatives for smoking cessation. “COP8 is a perfect opportunity for the UK to showcase this success and share our positive experience with the world,” she said. “E-cigarettes are a proven safer alternative to smoking and the UK boasts over 1.7 million former smokers who have converted from combustible tobacco to exclusively vaping instead. In the UK, the government has wisely recognized the significant benefits that tobacco harm reduction strategies can achieve and, as a result of positive messaging towards vaping with campaigns such as Stoptober, has seen smoking prevalence dramatically plummet in recent years.”
COP8 was immediately followed by the first Meeting of the Parties (MOP1) to the Protocol to Eliminate Illicit Trade in Tobacco Products, following the protocol’s entry into force in September. MOP1 took place October 8-10, 2018. The focus of the first conference was on a medium-term strategic framework and priorities, cross-border advertising, the environmental impact of tobacco use and cultivation, as well as global progress on reducing smoking worldwide.
Iran was elected as the head of COP9 to be held in October 2020, in The Hague, Netherlands.