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What is going wrong at the WHO FCTC?

10, Nov, 2016

The Framework Convention on Tobacco control (FCTC) is, in principle:

“[A]n evidence-based treaty that reaffirms the right of all people to the highest standard of health.”

It sets out some strong principles that few people would disagree with, such as:

“The  objective  of  this  Convention  and  its  protocols  is  to  protect  present  and  future  generations from the devastating health, social, environmental and economic consequences of tobacco consumption and exposure to tobacco smoke”

Some mission creep is already evident from the definition of tobacco products:

““tobacco products” means products entirely or partly made of the leaf tobacco as raw material which are manufactured to be used for smoking, sucking, chewing or snuffing”

Since sucking, chewing or snuffing don’t have anything to do with smoke exposure, and are of much less concern than anything that requires the user to set it on fire and inhale the smoke (with the possible exception of some products such as gutka, where ironically, the tobacco is probably the safest of its ingredients, and it is the non-tobacco components that cause most of the harm).

In an interesting, and somewhat ironic definition, the FCTC defines tobacco control as:

““tobacco control” means a range of supply, demand and harm reduction strategies that aim to improve the health of a population by eliminating or reducing their consumption of tobacco products and exposure to tobacco smoke”

(Note that it is “tobacco products and exposure to tobacco smoke”, so that the focus was clearly intended to be on smoked products)

Ironic, because if there is one thing the FCTC does not do, it is support harm reduction. It is opposed to smokeless tobacco, such as Snus, despite there being extremely good data on the long term advantages of the product on smoking rates and the related mortality and morbidity from Sweden.

Electronic cigarettes, or as the WHO would prefer to call them ENDS (Electronic Nicotine Delivery Systems) are also a target.

Why the WHO feels the need to oppose the use of a non-tobacco product that recruits its customers from existing smokers is itself a good question, but oppose they have.

In the build up to their latest meeting, COP7, the WHO published a report for the attendees (more on who goes later!). It can be found here, but I wouldn’t recommend reading it. It’s a godawful piece of work. So much so that the UK Centre for Tobacco and Alcohol Studies (which, it should be clear, is not affiliated to either the tobacco or e-cig industries, and is in fact moderately hostile to both) published a very thorough critique of it – and that I would recommend reading.

A good overall summary can be found in this paragraph:

“In our view, the WHO report succeeds in identifying a range of areas of uncertainty over the potential benefits and risks of ENDS to effective tobacco control policy. However, by doing so from a position of emphasis on the risks and disadvantages of these products which disregards their potential to reduce consumption of smoked tobacco, the report fails to deliver the equipoise required for dispassionate formulation of public health policy. The report also contains factual errors and misinterpretations of evidence available in the public domain; and refers at its outset to four reports, including two systematic reviews, commissioned by the WHO but as yet unpublished and hence unavailable for scrutiny.”

This was the state of play before the latest meeting (COP7) started.

It started with what has become the traditional expulsion of the public and media, in case anyone from the tobacco industry should sneak in as an observer. There is some quite interesting reporting of this here.

This opposition to openness and transparency, of course, flies in the face of pretty much every principle of good government, not to mention the UN’s commitment to press freedom (the UN is the parent organisation of the WHO).

It’s even too far for the FCA (Framework Convention Alliance), a sort of meta group of NGOs involved in tobacco control. Even allowing for the (not entirely unjustified) paranoia about the tobacco industry, the FCA support a much more liberal and transparent process:

Clearly though, the FCA view did not triumph, and all public and media were expelled.

This doesn’t actually prevent the tobacco industry from being involved, however. Far from it, in fact.

A number of governments still have state owned (in whole or part) tobacco companies. China is the single largest tobacco market in the world, and the state has a virtual monopoly through ‘China Tobacco’, whose website (in Chinese) can be found at tobacco.gov.cn. This isn’t the only example; the Japanese government owns 33% of Japan Tobacco.

The Thai government is also on this list, with the Thai Ministry of Finance operating the Thailand Tobacco Monopoly. Its website proudly boasts:

“TTM operates in the tobacco production and distribution business in order to contribute revenue to the State for the country development and plays an important role in the economic system of Thailand.”

The privately owned tobacco industry is prevented from even observing the meeting but states that own tobacco companies can not just observe, they can have a seat at the table.

This seems both massively hypocritical, and a massive conflict of interest.

Why is this relevant to the e-cig industry?

Following the abysmal report to the parties from the WHO, rumour (and rumour is all it can be, after the press and public were summarily ejected) has it that some countries are proposing a ban on e-cigs. Rumour also suggests that one of the lead players of this proposal was Thailand.

Thailand, a country with a state owned tobacco industry, is purportedly encouraging a ban on massively safer products which offer the potential to save millions of lives.

Somehow, I doubt that this is the vision of the people who created the FCTC.

Really, what went wrong?

 

Comments

I think this is showing that the WHO are hypocrites. Tobacco harm reduction works best if people stop smoking, Vaping has helped more people quit or seriously reduce smoking than any other method in the last 3 years, probably more than all the others together.
Big Tobacco has paid a lot in fines and changed NOTHING, yet they seem to be allowed to run the WHO when it comes to smoking

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