Tag: WHO

Abdicating Responsibility

Credit: Lisa F. Young
Divisive WHO report encourages countries to adopt harsh anti-vaping and anti-harm reduction positions.
VV Staff Report
By making demands for prohibitive curbs on the sale and use of electronic nicotine-delivery systems (ENDS), experts say the World Health Organization has declared war on tobacco harm reduction and the vaping industry. In its latest biannual report, WHO Report on the Global Tobacco Epidemic, 2021: Addressing New and Emerging Products, the global health agency’s director-general, Tedros Adhanom Ghebreyesus, stated that countries must remain vigilant to the risks presented by e-cigarettes and heated-tobacco products.
“While framing these products as a contribution to global tobacco control, the tobacco and related industries employ the same old marketing tactics to promote new tools to hook children on nicotine and circumvent tobacco legislation,” he writes. “At the same time, they continue to fight measures and legislation designed to protect people from the many harms of tobacco across the globe.”
In response to the report, Jamie Hartmann-Boyce, senior research fellow in health behaviors at the University of Oxford, said the WHO report’s view that vaping is “harmful” will wrongly concern vapers who have switched over from combustibles and dissuade smokers considering making the switch. He states that, while e-cigarettes are not risk free and people who do not smoke should not start vaping.
“Nicotine is addictive, but it’s not what causes the harm from smoking. Evidence shows e-cigarettes with nicotine can help people quit smoking and that they are considerably less harmful than smoking,” he states. “The latest report from the WHO should not discourage people who smoke from switching to an alternative product—one which evidence shows is less harmful to them and those around them.”
While the report found that more than four times as many people are covered under WHO-recommended tobacco control measures than in 2007, it expressed concern that children who use ENDS products are up to three times more likely to use tobacco products in the future. “Nicotine is highly addictive. Electronic nicotine-delivery systems are harmful and must be better regulated,” Ghebreyesus said.
Writing for InsideSources, Lindsey Stroud, a policy analyst with the Taxpayers Protection Alliance, states that the recently released WHO report is full of both alarmism and misleading information. Just six pages into the report, for example, the WHO asserts that youth who use e-cigarettes can double their risk of smoking combustible cigarettes.
“There is zero evidence to support this. According to data from the Centers for Disease Control and Prevention, in the United States, smoking rates among young adults are at their lowest levels with 11.9 percent of American adult smokers being between 18 to 24 years old in 2019. Conversely, in 2009, 22.5 percent of smokers were young adults,” she writes. “The report also fails to acknowledge harm reduction. In 212 pages, ‘harm reduction’ is mentioned a total of four times, and when mentioned, the WHO paints a picture that tobacco companies are using the concept to promote the use of their products and such marketing is ‘undermining successful tobacco control initiatives.’ If tobacco control measures were effective, smokers would not have developed the modern electronic cigarette.”
This is the first time that this WHO report has included data on ENDS. It states that a total of 111 countries regulate ENDS in some way. The report found that 32 countries (covering 2.4 billion people) have banned the sale of ENDS and an additional 79 have adopted at least one partial measure to prohibit the use of ENDS products in public places, prohibit their advertising, promotion and sponsorship, or require the display of health warnings on packaging. “This still leaves 84 countries where they are not regulated or restricted in any way,” according to the WHO.
In the report, Ghebreyesus states that in places where e-cigarettes are not banned, “governments should adopt appropriate policies to protect their populations from the harms of electronic nicotine-delivery systems and to prevent their uptake by children, adolescents and other vulnerable groups.”
The European Tobacco Harm Reduction Advocates (ETHRA), a group that advises on harm reduction policies, stated that while previous WHO reports were hostile toward ENDS products, the latest report “ramps up the rhetoric” and has transformed into an “all-out attack” on nicotine.
“The report states that progress has been made in the fight against tobacco but adds that there is a need to ‘tackle threats posed by new nicotine and tobacco products,’” the group wrote. “In an attempt to justify their calls for prohibitionist measures such as flavor bans and all out bans, the report makes unfounded claims that safer nicotine products are a gateway to smoking for youth and that their purpose is to ‘hook another generation on nicotine.’ The WHO’s dangerous position on tobacco harm reduction must be resisted in the strongest possible manner.”
Credit: Oleg Kachura
John Britton, emeritus professor of Epidemiology at the University of Nottingham and chair of the group that released the landmark 2016 Public Health England report that found e-cigarettes to be 95 percent safer than combustibles, said that the WHO does not comprehend the fundamental difference between addiction to tobacco smoking, which kills millions of people every year, and addiction to nicotine, which does not.
“The WHO is also evidently still content with the hypocrisy of adopting a position which recommends the use of medicinal nicotine products to treat addiction to smoking but advocates prohibition of consumer nicotine products, which do the same thing, but better,” said Britton. “The WHO is right that nonsmokers, especially children, should be discouraged from using any nicotine product. But for the more than 1 billion tobacco smokers in the world, electronic nicotine-delivery systems are part of the solution, not the problem.”
Rudiger Krech, the WHO’s director of health promotion, said that the challenges associated with ENDS regulation are hugely diverse and are evolving rapidly. Some devices are modifiable by the user, making nicotine concentration and risk levels difficult to regulate. Products have also been found to be marketed as nicotine-free but, when tested, are found to contain nicotine.
“Distinguishing the nicotine-containing products from the non-nicotine, or even from some tobacco-containing products, can be almost impossible,” he stated. “This is just one way the industry subverts and undermines tobacco control measures.”
One of the major controversies surrounding the report is that it was funded by Bloomberg Philanthropies, a foundation created by American billionaire and former New York City mayor Michael Bloomberg. Not coincidentally, Bloomberg was appointed the WHO global ambassador for noncommunicable diseases and injuries, a largely honorary title granted in recognition of the dollars his foundation spends on fighting nicotine policy from small cities to large countries.
“More than 1 billion people around the world still smoke,” Bloomberg stated in a release. “And as cigarette sales have fallen, tobacco companies have been aggressively marketing new products—like e-cigarettes and heated-tobacco products—and lobbied governments to limit their regulation. Their goal is simple: to hook another generation on nicotine. We can’t let that happen.”
Stroud stated that while the report was supported by Bloomberg Philanthropies, the report also strangely states that the report “should not be regarded as reflecting the position” of Bloomberg Philanthropies. “Yet, the report reads like a Christmas in July wish list for a Bloomberg-created anti-tobacco regime, she writes. “[While mayor of New York City] … in late 2019, on top of the $1 billion Bloomberg had already donated to anti-tobacco groups and efforts, the former mayor announced a $160 million campaign to ‘fight flavored e-cigarettes.’”
Knowledge-Action-Change (KAC), a private sector public health agency, condemned the WHO and “its single most significant funder for anti-smoking efforts, U.S. billionaire Michael Bloomberg,” for using the report to distract from “years of failure” in the fight against combustible tobacco.
“Unable to demonstrate that its tobacco control strategy has resulted in meaningful outcomes—the most important of which would be substantial declines in smoking—the WHO focuses instead on how many countries implement its ‘MPOWER’ measures,” according to a press release. “On closer inspection, even progress on the MPOWER measures is underwhelming. The WHO reports that 104 countries have introduced ‘one or more MPOWER measures at the highest level of achievement’ since 2007 but also states that 41 of the 49 countries that have not implemented a single measure are [low- and middle-income countries].”
MPOWER stands for: Monitoring tobacco use and preventive measures; Protecting people from tobacco smoke; Offering help to quit; Warning about the dangers of tobacco; Enforcing bans on advertising, promotion and sponsorship; and Raising taxes on tobacco. More than half of all countries and half the world’s population are now covered by at least two MPOWER measures at the highest level of achievement. This reflects an increase of 14 countries and almost one billion more people since the last report in 2019.
In the U.K., a group of lawmakers expressed concern over the influence exerted by Bloomberg Philanthropies on tobacco regulation policies, especially in low- and middle-income countries (LMICs). In a separate report, the U.K.’s All-Party Parliamentary Group for Vaping Inquiry (APPG) stated that The Union, another group funded by Bloomberg Philanthropies, as well as other anti-vaping nongovernmental organizations (NGOs) should not be permitted as “civil society observers” to the Framework Convention on Tobacco Control Conference of the Parties 9 (FCTC COP 9) meeting, which will dictate tobacco policies in LMICs are “hostile to the concept of tobacco harm reduction and thus the U.K.’s policy approach.”
The report has already begun to impact tobacco policy in LMICs. Shortly after its publication, Ukrainian lawmakers passed a new law after the WHO released its report that prohibits the use of ENDS in public places as well as advertising, sponsorship and promotion of e-cigarettes in the country. The law also bans the sale of flavored e-liquids other than tobacco flavors.
The parliamentarians said that justification for the regulations was based on the WHO’s new report that “suggests e-cigarettes are a gateway to smoking and that they are as harmful as conventional cigarettes,” according to the Independent Women’s Forum. Lawmakers also claimed the flavor ban would reduce underage vaping in Ukraine, while data from the U.S. concerning flavor bans has showed banning flavors actually increases youth use of combustible products.
Nancy Loucas, executive coordinator of the Coalition of Asia Pacific Tobacco Harm Reduction Advocates (CAPHRA) stated that the WHO’s latest attack on safer nicotine products deserves the global ridicule it has attracted. She says that the organization charged with looking after public health continues to ramp up its efforts to deny smokers access to products that can help them quit.
“Consumer advocates are increasingly angry that the WHO continues to promote its baseless and incredibly destructive view on vaping,” she said. “It comes despite leading scientific evidence confirming vaping is at least 95 percent less harmful than smoking and is the world’s most effective smoking cessation tool.”

August 24, 2021
Group: UK COP9 Delegation Must Support Science
A parliamentary group in the U.K. has released a report that criticizes anti-vaping groups funded by Bloomberg Philanthropies for being hostile to tobacco harm reduction (THR). The report also states that Bloomberg diminishes the rights of consumers and vapers in low and middle-income countries (LMICs) such as the Philippines.
Credit: Olrat
The UK’s All-Party Parliamentary Group for Vaping (APPG) said these anti-vaping “civil society observers” will be allowed to participate in the World Health Organization Framework Convention on Tobacco Control Conference of the Parties 9 (FCTC COP 9) in November this year, concluding that the WHO continues to attempt to discredit UK’s science and policy approach to address the smoking problem, reports the Manila Bulletin. It said THR is a public health approach which is supposedly one of the original commitments of FCTC.
The APPG warned about the participation of The Union, a group funded by Bloomberg Philanthropies, as well as other anti-vaping non-government organizations in the FCTC COP 9 meeting in November. The APPG is asking the UK delegation to the FCTC COP9 meeting to ensure that its national experience and real-life evidence/data are reflected in the discussions within the WHO.
The APPG also wanted to ensure that the WHO would not move away from the fundamental objectives set forth by the FCTC given its original commitment to harm reduction—a public health approach being opposed by some influential non-government organizations. “The majority of NGOs listed as ‘Observers’ are hostile to the concept of tobacco harm reduction and thus the UK’s policy approach. For instance, ‘The Union’ has advocated a complete ban on e-cigarettes and heated tobacco products in low and middle-income countries, which are home to 80 percent of the world’s smokers,” the APPG said in the report.
July 26, 2021
Jamaican Tobacco Company Warns Against Vape Rules
Jamaica’s largest tobacco distribution company Carreras Limited has cautioned the Government against an excessive regulatory regime for vaping and other tobacco products. Managing director of Carreras, Raoul Glynn, says the regulations will be tough to implement and enforce, and will impose provisions that will put the industry at a disadvantage.
Credit: Miro Novak
He stressed that the company took no issue with lawful, evidence-based regulation. However, excessive regulation will cause more revenue losses, pointing out that government revenue lost to the tobacco black market in 2020 was $2.1 billion.
“Jamaica is one of those markets that have a significant illicit component, not just on tobacco but other products [too],” Glynn told a joint select committee that is reviewing the country’s proposed Tobacco Control Act, according to the Jamaica Observer. “What we saw happening in 2017 when there was a significant increase in the excise, you had an almost immediate jump in the illicit volume, so consumption remains the same because of a proliferation of very cheap products that doesn’t pay the taxes.”
The company’s view is that new category products, such as e-cigarettes, and combustibles should be regulated separately. Lumping them with the same regulations for tobacco products would send an “incorrect and unhelpful message that both product categories have the same risk profile and perpetuate the misconception that tobacco and nicotine carry same risks,” according to Glynn.
The proposed legislation goes beyond traditional tobacco products to include prohibiting the use of electronic nicotine delivery systems (ENDS) in public spaces. This and other changes to the legislation is supposed to make Jamaica fully compliant with the World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC).
Glynn pointed to evidence that new category products have contributed to reduced smoking prevalence in countries with a more flexible regulatory landscape. It referenced the United Kingdom’s House of Commons Science and Technology Committee, which found that e-cigarettes could significantly accelerate already declining smoking rate and are about 95 percent less harmful than conventional cigarettes due to the absence of tar and carbon monoxide.
He noted that the Canadian Government says switching from tobacco cigarettes to vaping products will reduce exposure to many toxic and cancer-causing chemicals. The tobacco company’s view is that e-cigarettes should be regulated proportionately on an evidence-based approach, taking into consideration freedom to innovate, dialogue and responsible marketing freedoms, according to Glynn, who said also that the legislation, technically, places a ban on the sale of cigarettes in all public spaces, despite arguments that it does not.
Glynn also cautioned that the law puts small businesses at a severe disadvantage by prohibiting retailer incentives and promoting discounted products.
July 6, 2021
Think Tank to Debate COP9 Impact on Vapers
The U.K. Institute of Economic Affairs (IEA) will host a discussion today on the impact of the World Health Organization’s ninth Conference of the Parties (COP9) to the Framework Convention on Tobacco Control (FCTC), which is scheduled to take place on Nov. 21 in the Netherlands.
The COP is the supreme decision-making body of the FCTC, where all parties to the FCTC meet biennially to review the implementation of the convention and adopt the new guidance. For the first time since leaving the European Union, in November 2021, the U.K. will send a delegation to the COP.
According to the IEA, COP9 poses a significant threat to the U.K.’s approach to harm reduction policy. “The WHO is increasingly, and against the clear evidence, positioning itself as an enemy of vaping,” the think tank states on its website. “The U.K. is a world leader in tobacco harm reduction, and a significant reason for this is our comparatively liberal approach to vaping products and e-cigarettes.”
Participants in the IEA forum will discuss who represents the U.K. at COP, how decisions are reached, the impact of these decisions on the U.K.’s harm reduction progress and the country’s 2030 smoke-free target, among other topics.
Speakers includes IEA Director General Mark Littlewood (chair), Matt Ridley (vice-chair of the All-Party Parliamentary Group on Vaping), Christopher Snowdon (IEA head of lifestyle economics) and Louis Houlbrooke (NZ Taxpayers Union).
The discussion can be followed live on the screen or here.
June 24, 2021
CAPHRA: World Vape Day 2021 Largest Event Ever

A vaping group announced World Vape Day 2021 was an unprecedented success with social media engagement about the annual global celebration up considerably. The Coalition of Asia Pacific Tobacco Harm Reduction Advocates (CAPHRA) estimates report a 125 percent increase in Twitter traffic about World Vape Day from 29 May to 2 June compared to the same period last year.
This year’s World Vape Day, on 30 May, highlighted smoke-free products as ‘the better choice’ to combustible cigarettes which are linked to more than eight million premature deaths each year. “The social media analytics for World Vape Day are impressive. It enjoyed huge growth in the number of postings, followers, and positive comments. Without doubt, #WVD21 gained much more traction than 2020’s event,” says Nancy Loucas, executive coordinator of CAPHRA.
CAPHRA executive coordinator Nancy Loucas
CAPHRA and consumer advocacy groups in the Asia Pacific region called on the World Health Organization (WHO) and governments to provide smokers with better access to innovative, safer nicotine products. Loucas says the #WVD21 hashtag achieved significant public use for a number of reasons.
“The WHO and many in the media seemed to have rebooted their campaign against vaping lately which only energizes the 68 million people globally who have switched from smoking to vaping, saving millions of lives every year. Their success and personal stories are the most powerful evidence we have, highlighting vaping as the world’s most effective smoking cessation tool,” she says.
Peter Paul Dator, President of the Philippines consumer group Vapers PH and CAPHRA member, says excitement is building ahead of the Senate’s approval given the country’s stubbornly high smoking rates.
Peter Paul Dator of Vapers PH
“If you judge it on information, views, and support exchanged across our social media platforms, World Vape Day this year was undoubtedly the biggest we’ve seen in the Philippines. It was boosted by the fact it’s a really positive time as we await the Senate’s formal support for vaping,” says Dator.
World Vape Day is a celebration of vapers making the choice to make the switch to a healthier, smoke-free lifestyle.
June 11, 2021
China Vape Stocks Stumble After NHC,WHO Health Warning
E-cigarette stocks listed on the Stock Exchange of Hong Kong plunged in the afternoon session on Wednesday, following an official warning of that e-cigarettes can cause damage to consumer’s health. Shenzhen-based Smoore International, the world’s largest vaping device manufacturer, saw its shares slump nearly 20 percent on the exchange near the end of the afternoon session, before finishing down 17.1 percent.
Credit: Boonchok
By comparison, the benchmark Hang Seng Index gained 0.88 percent. China Boton Group, an vapor industry manufacturer also based in Shenzhen, lost 17.94 percent in Hong Kong trading, while Hong Kong-based Huabao International Holdings shed 7.69 percent, according to news in China’s Global Times.
The rout was triggered after the National Health Commission (NHC) on Wednesday unveiled a report on the health risks of smoking cigarettes, jointly with the World Health Organization’s (WHO) county office in China, which said that there’s sufficient proof that e-cigarettes are unsafe and harmful to health.
The country’s population of smokers has topped 300 million, with the smoking rate for those aged 15 and above standing at 26.6 percent and the percentage of male smokers hitting 50.5 percent, according to the report. Cigarettes claim the lives of more than 1 million people in the country per year. The annual number is estimated to rise to 2 million by 2030 and then to 3 million by 2050, assuming the absence of effective actions.
In 2016, a groundbreaking 200-page report that supports e-cigarettes as a tool to quit smoking and demolishes several vaping myths in the process was released by one of the world’s most prestigious medical organizations. The Royal College of Physicians (RCP), the most respected medical institution in the United Kingdom, concluded e-cigarettes are 95 percent safer than regular cigarettes and are likely to be hugely beneficial to public health.
Several other studies have found similar conclusions over the last five years since the RCP study was published. The WHO has long refused to see e-cigarettes as a harm reduction product.
Nonetheless, Hong Kong-traded BYD Electronic still posted a massive gain in the final hour of trading, soaring as much as 22.91 percent before ending up 11.73 percent, on reports that the company has finalized patenting its e-cigarette business, which is expected to begin mass production in June. Its parent company BYD closed up 2.39 percent in the Hong Kong market on Wednesday, while edging down 0.2 percent in the Shenzhen market.
May 26, 2021
Consumer’s Choice
INNCO works with consumer advocacy groups to promote tobacco harm reduction around the globe.
By Timothy S. Donahue
Most of the world’s cigarettes are consumed in low-income to middle-income countries (LMICs). From Armenia to Zambia, these countries can also have high rates of adolescent smoking, particularly among males. Rates in some countries can reach as high as 46 percent, according to the U.S. National Institutes of Health. Research suggests that 80 percent of the world’s combustible cigarette users are in LMICs.
While numerous studies have shown otherwise, the World Health Organization (WHO) has long insisted that less risky nicotine products, including vapor products and e-cigarettes, are as harmful and dangerous as combustible tobacco products and should be banned or heavily regulated. The International Union Against Tuberculosis and Lung Disease (The Union), a Bloomberg partner for The Initiative to Reduce Tobacco Use, published its fourth position statement on e-cigarettes last year. It called for a blanket ban on all electronic nicotine-delivery systems (ENDS) and heated-tobacco products (HTPs) in all LMICs. These organizations, typically through groups funded by Michael Bloomberg, the billionaire anti-smoking advocate, will often donate millions of dollars to poor or struggling countries if governments agree to ban or heavily restrict access to less risky products.
As a result of policies based on false information from organizations such as The Union and the WHO, nicotine consumers in LMICs often have no delivery system available other than combustible products. Experts say that the lure of massive amounts of funding is just too great for such countries to resist.
The International Network of Nicotine Consumer Organisations (INNCO), a global advocate for sensible tobacco harm reduction (THR), states in a recent position paper that bans on ENDS are overly simple solutions that make the problems that come with combustible cigarette use worse. It also states that reduction and substitution are valid goals for smokers in LMICs as replacing combustible tobacco with alternative nicotine products can reduce risk of harm by at least 95 percent.
“The hundreds of millions of people who smoke in these countries should have the ability to make decisions about safer nicotine products, particularly when their own health is on the line,” said Samrat Chowdhery, president of INNCO’s governing board. “Overly simplistic policy solutions, such as proposed bans on all ENDS and THR products by the Bloomberg Philanthropies-funded The Union, are being offered as a blunt and impractical tool for a situation that requires pragmatism and nuance.”
The need for INNCO
INNCO was founded in 2016 to build cooperation between the growing number of global associations that advocate for THR. An organization can join INNCO if they are nonprofit, consumer-controlled and focused on tobacco harm reduction. The organization has 40 members in 35 countries, including the U.S.-based Consumer Advocates for Smoke-free Alternatives Association, a well-established advocacy group that raises awareness and protects the rights of consumers to access reduced harm products. INNCO also has members from Canada, Denmark and Greece to the Philippines, Brazil and Kenya.
The organization continues to grow. “We are enlisting new members in several countries,” Chowdhery told Vapor Voice after the release of the position paper in March. “We are helping consumers form organizations where there are none. Africa came on board, where we have four, five members from that region this year, and since 80 percent of smokers do live in LMICs, it’s an additional focus that we have developed. It is something that, with this paper, we want to really say, ‘OK. We want to participate in discussions on these issues in LMICs.’”
Samrat Chowdhery
When The Union released its position paper calling for outright bans, Chowdhery says the recommendations were discriminatory. It was centered on the idea that if LMICs would not be able to enforce regulations, the only other option was a total ban on reduced-risk products.
“They were not very mindful of the situation where if you could not regulate, it’s likely that you will also not be able to enforce a ban either. We know this because it’s what has happened in Mexico, Brazil and Thailand, where there have been bans, but products are very easily available,” explains Chowdhery. “If they would have instead implemented some sort of a regulatory control, you could ensure that there are product standards, they’re not sold to minors … but only having them available on the black market, those controls are not there, and you end up increasing the level of population harms to health.”
Typically, when organizations like the WHO or United Nations develop policy, the organizations involve the industry stakeholders. After all, these are the people and businesses that the policies impact, says Chowdhery. Tobacco is the only industry that consumers and stakeholders do not have a say in policymaking.
“The media should be taking this up. There is some trickery here,” he says. “The way the debate has been developed and the way Article 5.3 is getting misused all the time—it is a tough fight, but we’re up for it … we have our lives in the balance.” Article 5.3 of the WHO Framework Convention on Tobacco Control (FCTC) states that when setting and implementing their public health policies with respect to tobacco control, “Parties shall act to protect these policies from commercial and other vested interests” of the tobacco industry. Many anti-tobacco organizations have interpreted this as a ban on all interactions with the industry.
Words of reason
In the paper, INNCO claims that blanket bans on vaping and HTPs are a detriment to LMICs. The report, “10 Reasons Why Blanket Bans of E-Cigarettes and HTPs in low-[income] and middle-income Countries (LMICs) Are Not Fit for Purpose,” warns policymakers that limiting nicotine consumption options to reduce harm will only increase the number of people smoking combustible tobacco. The paper lists the following reasons:

Bans are an overly simplistic solution to a complex issue and will not work.

Prioritizing the banning of reduced harm alternatives over cigarettes is illogical.

Reduction and substitution are valid goals for smokers in LMICs.

People who smoke have the right to choose to reduce their own risk of harm.

Reduced harm alternatives can significantly contribute to the aims of global tobacco control.

Lack of research in LMICs is not a valid reason to ban reduced harm alternatives.

The prohibitionist approach in LMICs is outdated, unrealistic and condescending.

Bans will lead to illicit markets with increases in crime and no tax revenue.

Banning reduced harm alternatives leads people back to smoking and greater harm.

Blanket bans in LMICs are a form of “philanthropic colonialism.”
INNCO says many LMICs risk an increase in smokers as a result of their policies. Leveraging the paper’s findings, INNCO states that it will work with its global membership to inform policymakers in developing nations to help achieve risk-relative regulations and access to THR products
“Africa is home to some of the highest-ranked smoker countries on the planet,” said Joseph Magero, chairman of the Campaign for Safer Alternatives, a pan-African nongovernmental member organization dedicated to achieving 100 percent smoke-free environments in Africa. “While improving overall public health has made great strides in these regions, efforts to directly address smoking cessation and harm reduction strategies have lagged due to limited or no access to safer, noncombusti[ble] nicotine products. By denying smokers access to much safer alternatives while leaving cigarettes on the market, policymakers would leave only two options on the table—quit or die.”
Nancy Loucas of the Coalition of Asia Pacific Tobacco Harm Reduction Advocates (CAPHRA), a grassroots alliance of THR advocacy organizations and an INNCO member, said a blanket ban in LMICs is a form of philanthropic colonialism, suggesting that these countries and their citizens cannot be trusted with any level of self-determination. “Inhabitants are treated as second-class citizens, which is offensive,” she said. “There is no benefit in limiting choice of safer nicotine products but only the potential for increasing harm.”
Samsul Arrifin, president of the Malaysian Organisation of Vape Entities (MOVE) and an INCCO member, concurred with the INNCO assessment, saying that “any move to deprive smokers and consumers of better alternatives to cigarettes, such as vapes, would only contribute [to] the problem that [it] seeks to address.”
Francisco Ordonez of the Asociacion por la Reduccion de danos del Tabaquismo Iberoamerica, a network of consumer organizations in Latin America and an INNCO member, says that few LMICs have adopted even the most basic prevention measures suggested by the WHO. “Policymakers should embrace harm reduction as a valid goal, particularly in LMICs where access to cessation programs is extremely limited,” said Ordonez. “Replacing combustible tobacco with alternative nicotine products can significantly reduce the risk of harm by at least 95 percent. It works in industrialized nations and can do the same in LMICs.”
The Bloomberg conundrum
Much of the ire of the THR community is reserved for Bloomberg Philanthropies (BP). In September 2019, Bloomberg and Matthew Myers, president of the nonprofit Campaign for Tobacco-Free Kids, launched a $160 million three-year campaign to end what they described as an epidemic of e-cigarette use among kids. The campaign is supported by several large nonprofits, like the Truth Initiative, American Cancer Society, American Heart Association and American Lung Association. Together, the organizations are pushing for a national ban on flavored ENDS products in the U.S.
Chowdhery says that Bloomberg is using philanthropy in an unprecedented manner. “I’ve not seen anyone do this. This is so insidious. You have Bloomberg-funded attack groups,” says Chowdhery. “They were anti-smoking for a long time until these new [reduced-risk] products came on the market. Then they expanded their focus to become anti-nicotine … they are becoming more and more radicalized, proposing more and more extreme ideas as we go along. You have groups that their only stopping-tobacco tactic is just attacking people. That’s their job. That’s all they do.”
Bloomberg, both as an individual and through his foundation, has committed nearly $1 billion to combating tobacco use worldwide, most of it focused on LMICs, according to BP. “These policies are what we call philanthropic colonialism because they’re just pushing an idea they have, an idea a New York billionaire has, on countries, which may not be suited for this,” explains Chowdhery. “He’s not proposing those policies [total bans] in the U.S.”
Chowdhery says Bloomberg and his charities spread lies and disinformation without any regard for the negative impact on public health. During an appearance on CBS News, Bloomberg suggested vaping lowers IQ, even though there is no evidence about a relationship between nicotine use and intelligence.
Chowdhery hopes the INNCO position paper will be read by the policymakers working with Bloomberg. “That was the main objective of the paper: to reach out to policymakers, reach out to media and professionals and let them know … what is being proposed has another side to it,” said Chowdhery. “See, this is a David and Goliath problem. What they have are well-funded organizations to push this narrative. And what they also have is credibility because a lot of this is coming from [well-known nonprofit groups]. Even if they publish a paper with lots of misinformation and have a disclaimer: ‘We received a million dollars from Bloomberg but that did not influence our work.’ That is a big problem.”
The push forward
The pandemic hit INNCO hard. Chowdhery, a former journalist, founder of the Council for Harm Reduced Alternatives and the director of the Association of Vapers India, was approached to head INNCO in July 2020. He said the organization had a lot of plans for the year, including regional meetings and setting up networks, projects that required a lot of on-ground activities. Then everything needed to be scaled back. The year 2020 became about recalibrating INNCO’s efforts. “The year was full of uncertainty and adapting and doing things differently. We did a lot of online meetings and a lot of internal objectives online,” said Chowdhery. “We enrolled more members. When we put out a call for a CEO, we got 400 resumes.”
Chowdhery says that the main goal for INNCO now is to have a say in policymaking and be recognized as a legitimate stakeholder in this tobacco control intervention. It won’t be easy. Already, groups funded by Bloomberg are trying to discredit INNCO. “Our strength is our membership base. They are organizations that might be poor but [are] passionate, and they are volunteering their time and effort[s]. That is the real strength, and we need to leverage that and get everyone on the same platform so that we speak with common messaging,” says Chowdhery. “This is the first year that we actually have a budget to do our work. Unfortunately, we’ve not started because of Covid-19. We’re getting a new CEO, who should be with us soon. Things are looking really good.”
In a recent essay in the journal Science, “Evidence, Alarm and the Debate Over E-Cigarettes,” five experts in public health state that it is a mistake to restrict access to vaping products while leaving deadly cigarettes on the market. The authors include Cheryl Healton, the former chief executive of the Truth Initiative, who is dean of the New York University school of public health, as well as the deans of the schools of public health at Ohio State and Emory universities. The essay concludes: “Careful analysis of all the data in context indicates that the net benefits of vaped nicotine products outweigh the feared harm to youth.”
Chowdhery says that 15 years ago, there were no groups championing tobacco consumer rights. It’s now, when safer means of consuming nicotine are available, that consumers want to have access to them. “We consider that a right. This campaign of misinformation and regulatory overreach is a disaster waiting to happen,” says Chowdhery. “People in tobacco control, they’re earning paychecks to develop a policy which they then get passed through Parliament somewhere and they believe their work is done and they go home. The problem is, did legislation stop the use of that product that day? No, it just went underground. It became riskier. Now, it’s costing people their lives.”
May 7, 2021
UKVIA Condemns WHO Stance on Vaping Products

John Dunne (Photo: UKVIA)
The U.K. Vaping Industry Association (UKVIA) has joined the chorus of voices condemning the World Health Organization (WHO) for its urging of countries to take an aggressive anti vaping stance ahead of a crucial health summit later this year.
According to leaked documents reported in the Daily Express, the WHO plans to use November’s COP9 summit in the Netherlands as a platform to tell leading international health figures that e-cigarettes are as dangerous as smoking tobacco.
The UKVIA joins the criticism of the WHO by the All-Party Parliamentary Group (APPG) Chair Mark Pawsey MP, who has called into question why the U.K. government is continuing to fund the body to the tune of £340 million ($471.8 million) over the next four years.
The UKVIA notes that this action flies in the face of the scientific reality of vaping in the U.K., which has seen millions of people quit smoking in recent years. Research by British scientists has consistently shown vaping to be the most popular and successful aide to quitting smoking.
The Cochrane Review into e-cigarettes highlights that existing studies show that vaping is nearly 50 percent more effective in helping smokers quit cigarettes than other methods of smoking cessation, according to the UKVIA. The review found that as many as 11 percent of smokers using a nicotine e‐cigarette to stop smoking might successfully stop compared to only 6 percent of smokers using nicotine‐replacement therapy or nicotine‐free e‐cigarettes or 4 percent of people having no support or behavioral support only.
The vaping industry here in the U.K., together with the All-Party Parliamentary Group for Vaping, is right to call out these baseless attacks on the sector.
John Dunne
There are already 3.2 million adults in Great Britain who have made the switch from smoking. The vaping industry needs to be supported as a British success and able to assist the remaining 6.9 million adult smokers in the U.K., according to the UKVIA.
“The stance of the World Health Organization is extremely concerning,” said John Dunne, UKVIA director general, in a statement. “The vaping industry here in the U.K., together with the All-Party Parliamentary Group for Vaping, is right to call out these baseless attacks on the sector. Vaping is a great British success story, enabling millions of people to switch from smoking.
“The APPG is also right to call for the U.K. government to reconsider the level of its funding to the World Health Organization in light of these reports. Thankfully, now that the U.K. has left the EU, it is now longer bound by the ridiculous and quite frankly dangerous WHO messaging urging the bloc to treat vaping in the same way as smoking.”
May 3, 2021
Asian THR Group Warns Against Open System Ban

Photo: Olgacanals | Dreamstime
Millions of vapers could feel forced to return to smoking if national governments adopt a proposal from the World Health Organization (WHO) on e-cigarettes, warns the Coalition of Asia Pacific Tobacco Harm Reduction Advocates (CAPHRA)
A new report published by WHO’s tobacco regulatory committee recommends nearly all vapes—especially “open systems”—be banned. It also demands existing restrictions on cigarettes be applied to emerging products, presumably so smokers won’t learn about them.
In the open system, which is the preferred way of vaping for many people across Asia, the consumer manually refills the liquid to be vaporized. According to the WHO, this system allows for the addition of substances which could make the product more harmful.
“The latest recommendation from WHO defies all logic,” said Nancy Loucas, the executive coordinator of CAPHRA, in a statement. “If countries adopt the recommendation to ban open-system vapes, years of hard work by ex-smokers as well as good public policy will be rendered meaningless.”
“Let there be no doubt: vapers will then go back to cigarettes, which is the worst possible outcome.”
“Banning any product is not the answer, nor is applying blanket cigarette rules to all emerging products. Bans encourage the black market. Bans do not allow for proper consumer protection,” Loucas said.
CAPHRA is calling on governments to adopt evidence-based, common sense regulations for all vaping products.
“Just last week, the U.K.’s leading health agency, Public Health England (PHE), concluded that nicotine vaping products were the most popular aid used by smokers trying to quit,” Loucas said.
“On the one hand, you have a local public health agency looking into the evidence and ways in which smokers can be encouraged to quit smoking and vape, and on the other you have a global agency stuck in their old ways of believing prohibition is the answer to everything.”
“WHO’s attitude to e-cigarettes has been devastating for millions and millions of smokers and vapers alike all around the world,” Loucas said.
CAPHRA said it’s only through regulating products can vapers remain protected, encouraged to stop smoking, and as a result, achieve good public health outcomes.
March 5, 2021
Health Experts: WHO Must Embrace Vapor to Save Lives
New Year resolutions always include commitments to quit smoking. Most people fail not for want of trying but for want of options that can help them. Our interventions to date are not good enough. Will the World Health Organization’s (WHO) campaign to help 100 million people quit tobacco (WHO News Release Dec 8, 2020) make a difference? Is the WHO willing to embrace new methods and emerging scientific data to course correct and in the process save millions of lives?
Credit: Martin Budenbender
The WHO depends upon “new contributions from partners” to help smokers quit (WHO News Release Dec 8, 2020), Derek Yach and Chitra Subramaniam write in an opinion for Business Insider. They are as diverse as Amazon Web Services, Facebook, and Google. These digital giants are not known for their solutions to help people quit. Worse, WHO has turned to Allen Carr’s Easyway that has published studies of dubious quality and has a strong opposition to the use of nicotine even in nicotine replacement therapy (NRT Allen Carr, BMJ 2006).
Unfortunately, most of the countries listed as priorities for this campaign have yet to include NRTs in their national drug formularies despite WHO having included it in the Essential Drug list way back (Application for Inclusion of Nicotine Replacement Therapy (NRT) in the WHO Model List of Essential Medicines, WHO, 2009).
WHO should conduct an independent review of the evidence of each partners’ interventions in the very diverse set of countries where they will be tested. Such a review is a basic requirement for making global recommendations. It must be as rigorous and science-based as the processes that were put into action to approve COVID 19 vaccines. (WHO News Release Dec 31, 2020)
Florence, WHO’s robotic digital health worker was launched with this campaign to help smokers quit. Dr. Yach tried it (see Speak to Florence) but found Florence true to its name – robotic and unable to answer simple questions and clearly out of depth when asked real world questions outside of the algorithm. A gimmick of this nature is disrespectful as it mocks those seeking to quit.
It seems that WHO is far more interested in ending the use of tobacco harm reduction products than in saving lives.
The latest Global State of Tobacco Harm reduction (GSTHR) report (GSTHR, Burning Issues 2020) indicates that almost 100 million people are now using a range of such products with most completely off combustible cigarettes and toxic smokeless tobacco products. This report provides convincing evidence that harm reduction products, including snus, e-cigarettes and heated tobacco products, are more effective means of quitting than the use of NRTs, and substantially lower exposure to harmful products of combustion seen in cigarettes and bidis.
In contrast, WHO’s latest report from their expert committee on Tobacco Product Regulation, released December 23rd, recommends banning and prohibiting e-cigarettes and heated tobacco products. This echoes a call by the Union, a Bloomberg Philanthropy financed NGO, to all low and middle income countries (LMICs) to ban such products to “avoid being distracted” by them (WHO Expert Committee Meeting Report, Dec 23, 2020).
Distraction from what one may ask?
This “expert” report did not address snus. That may be because WHO accepts the EC ban as being the basis for its policies despite the recent USFDA decision that led to it being the first class of tobacco harm reductions products to pass its rigorous evaluation process (FDA News Release, Jul 2020).
Before the FCTC negotiations began 20 years ago under Dr. Yach’s leadership of the Tobacco Free Initiative (TFI) WHO invited tobacco industry scientists to present to the fledgling Tobacco Products Regulation Expert Committee on their progress in developing safer tobacco products. The presentations were not useable then for any specific harm reduction recommendations to be made. The hope remained that in time scientific progress would follow. For that reason – and in good faith – harm reduction found its way into the very definition of tobacco control used in the FCTC (WHO FCTC 2004).
Decades have passed and tobacco consumption continues to kill people mainly in LMICs. Science and innovation have permeated every sector of society. Dirty legacy industries are now leaders in driving sustainable development. This is underway in the oil and gas, transport, mining and food sectors. And as the GSTHR and our Tobacco Transformation Index (https://tobaccotransformationindex.org/) bears out, such transformation is underway in the tobacco sector as well. This transformation should be embraced by the WHO not shunned.
Instead of looking into the future and enabling global leadership, the United Nation’s (UN) top health agency is digging into its past with a ferocity that is difficult to comprehend. Ignoring decisions by the United States Food and Drug Administration (FDA), Cochrane Collaborating Centers and other regulatory and science oversight groups indicating the power of THR to increase quit rates more effectively than NRTs for example, or the potential to sharply reduce risks associated with combustible cigarettes or toxic smokeless products.
One hopes that as 2021 unfolds, WHO will take a fresh look at the power of THR to accelerate an end to smoking. A good way to start would be to summon the leading scientists from tobacco and e-cigarette companies to present to the WHO Tobacco Product Regulations Expert Committee in a series of open sessions. The aim could be simple: to assess whether industry has made material progress in developing products able to end smoking in order to truly judge whether the unilateral bans and prohibitions are warranted.
From what we know, the answer is yes. WHO’s unambitious aim of helping 100 million of the 1.1 billion tobacco users quit could be revised upwards dramatically if they were to open up to rapid progress underway in the very companies we rightfully condemned 20 years ago.
Knowledge that ignores science cannot help public health. We are seeing it with the COVID 19 crisis. We are seeing it differently in tobacco control. Time is not on our side.
The views expressed in the above opinion are those of the authors’ and do not necessarily represent or reflect the views of Vapor Voice or its parent organization.
Derek Yach is president of the Smoke Free Foundation, USA. He has spent four decades advancing global public health especially chronic diseases. He was a key architect of the WHO’s FCTC.
Chitra Subramaniam is the founder of CSD consulting Switzerland. A journalist by training and a media entrepreneur she writes on public health, development and trade
January 14, 2021