The World Health Organization is reminding its member states of their tobacco obligations under the WHO Framework Convention of Tobacco Control (FCTC) especially in relation to heat-not-burn products (HNB).
“Heated tobacco products are tobacco products, meaning that the WHO FCTC fully applies to these products. [Rules] obliges Parties, to prohibit ‘all forms of tobacco advertising, promotion and sponsorship that promote a tobacco product by any means that are false, misleading or deceptive or likely to create an erroneous impression about its characteristics, health effects, hazards or emissions,” the statement reads.
The Who claims that reducing exposure to harmful chemicals in HNB products does not render them harmless, nor does it translate to reduced risk to human health. “Indeed, some toxins are present at higher levels in [HNB] aerosols than in conventional cigarette smoke, and there are some additional toxins present in [HNB] aerosols that are not present in conventional cigarette smoke,” the release states The organization also claims that the health implications of exposure to HNB products are unknown.
Even though the US Food and Drug Administration (FDA) authorized the marketing of a HNB product, Philip Morris’ IQOS, the WHO says there is no proof that HNB products are safer than cigarettes. “Given that health may be affected by exposure to additional toxins when using [HNB], claims that [HNB] products reduce exposure to harmful chemicals relative to conventional cigarettes may be misleading.
“Moreover, the relevant orders grant a temporary market authorization within the US and are based on factors specific to the US, which is not a Party to the WHO Framework Convention on Tobacco Control (WHO FCTC).”
The WHO has long spread misinformation concerning new tobacco products even though several studies say they are further down the ladder of harm reduction than combustible cigarettes.
It’s official. The Trump administration has withdrawn the United States from the World Health Organization. The news comes as the Covid-19 pandemic continues to grip the globe and infections spike across the U.S.
Withdraw requires a years notice, so it will not go into effect until July 6, 2021. This raises the possibility the action could be overturned.
Congress received formal notification of the decision on Tuesday, more than a month after President Donald Trump announced his intention to end the U.S. relationship with the WHO and blasted the multilateral institution as a tool of China, according to an article in USA Today.
Democrats said the decision was irresponsible and ill-considered, noting it comes as the pandemic is raging and international cooperation is vital to confront the crisis.
“This won’t protect American lives or interests – it leaves Americans sick & America alone,” Sen. Bob Menendez, the top Democrat on the Senate Foreign Affairs Committee, tweeted after receiving the White House’s notification. “To call Trump’s response to Covid chaotic & incoherent doesn’t do it justice.”
The formal withdrawal comes as the United States nears 3 million reported coronavirus cases and more than 130,000 deaths, according to Johns Hopkins University data. Globally, there have been 11.6 million cases and almost 540,000 deaths, according to the story.
Trump and his advisers have blasted the WHO for failing to press China to be more transparent about the scope and severity of the Covid-19 outbreak, which began in Wuhan, China.
Trump has said that China “has total control” over the WHO, even though it contributes far less than the US to the health organization’s budget. The U.S. has contributed approximately $450 million dollars a year, according to the story.
Amanda Glassman, a public health expert and executive vice president of the Center for Global Development think tank, noted the world doesn’t just face today’s threat of Covid-19 but also the threat of future pandemics, which are more likely because of increased zoonotic transmission.
“We know beyond reasonable doubt that vaping and other smoke-free nicotine products are very much less risky than smoking and that those who switch completely see rapid improvements in their health. Yet the WHO continues to promote the outright prohibition or extreme regulation of these products. How can it make sense to ban the much safer product when cigarettes are available everywhere?”
“[The] WHO is treating vaping products as though they are part of a ploy by Big Tobacco. But they have this 100 percent wrong. In fact, the new products are disrupting the profitable cigarette trade of the tobacco industry and driving down cigarette sales. It is exactly what we need from innovation, but [the] WHO and its private funders have lined up to oppose it with calls for prohibition. Though they don’t seem to realize it, they are siding with the cigarette interests of Big Tobacco, erecting barriers to entry to new technology and protecting the incumbent cigarette oligopoly.”
“When smoking is by far the dominant cause of disease caused by tobacco, why would the WHO use World No Tobacco Day to target one of the most effective and popular alternatives to smoking? We rarely see the vaping industry advertise to adolescents and we never see kids used in commercial vaping ads—but on World No Tobacco Day we have the absurd spectacle of [the] WHO promoting adverts with children vaping. What on Earth do they think they are doing?” – Clive Bates
“Unless it does something different and embraces innovation in tobacco policy, [the] WHO will miss the targets for reducing cancer [and] heart and lung disease by some distance. Encouraging people to switch to low-risk alternatives to smoking could make a large difference to the burden of disease by 2030 if [the] WHO got behind the idea instead of blocking it.”
“On World No Tobacco Day, the WHO should be driven by one overriding question: How do we get smoking down for the greatest number at the greatest rate? We know [the] WHO embraces harm reduction in other areas of public health, including for illicit drugs and sexual health. If [the] WHO wants to even come close to meeting its targets to reduce disease, it needs a strategy for smokers who can’t or won’t quit nicotine, and the rise of smoke-free products since 2010 makes that a practical option. [The] WHO’s ‘quit or die’ approach to smokers and opposition to harm reduction makes no sense.”
“When [the] WHO set out to build an international treaty for tobacco control from 2000, the goal was clear—it was trying to tackle the worldwide epidemic of smoking-related disease. Somewhere along the way, [the] WHO seems to have lost its sense of purpose and developed a closed mentality that is leading it to take unworkable, nonnegotiable or counterproductive positions that are not backed by sound science. It seems to have neglected its core mission, ‘the highest possible level of health for all people,’ including the 1 billion smokers globally, most of whom want to avoid disease and premature death.”
Experts say the spread of misinformation about vapor has a negative effect on public health.
By Timothy S. Donahue
It can be confusing for even the experts. During the pandemic, the vapor industry has struggled under conflicting reports about whether vaping makes you more susceptible to catching Covid-19. Several media stories have speculated that vaping could make having the illness even more severe (see “Up in the Air,” page 16). Anti-tobacco groups quickly began to claim smoking and vaping could even help spread the disease although no studies have found this to be true.
In the U.S., these news stories have prompted politicians to demand that the U.S. Food and Drug Administration (FDA) temporarily ban e-cigarettes. Several states are either considering or have passed vaping regulation as part of their coronavirus response. Globally, the World Health Organization (WHO) has accused the tobacco (and vapor) industry of creating doubt about the risks of nicotine and tobacco product and Covid-19. One country, South Africa, went as far as to ban tobacco products altogether as part of its coronavirus lockdown.
The controversy grew in April and May as researchers noted a remarkable underrepresentation of smokers among Covid-19 patients who had been admitted to the hospital. “This has led some scientists to hypothesize that there may be some protective effect from nicotine specifically to do with coronavirus,” said Guy Bentley, director of Consumer Freedom Research at the Reason Foundation, a libertarian think tank. Currently, clinical trials are underway investigating the effects of nicotine patches in France and now in Wales.
During a webinar held by the Reason Foundation in mid-May, a panel of harm reduction experts weighed in on the supportive new research as well as the misinformation being disseminated and the impact these factors have on both the vapor industry and overall public health.
Sally Satel, resident scholar at the American Enterprise Institute, an influential right-wing think tank, noted that every observational study concerning Covid-19 has seen that smokers are underrepresented in patients who are admitted to the hospital. These included thousands of patients in more than two dozen studies from several countries, including Italy, France, China and the United States. She also said that many of these studies have not been peer-reviewed, and concerns about data collection exist. “Nevertheless, they’re exciting, and they are especially exciting … because they are so counterintuitive,” said Satel.
Satel pointed to one study conducted by Konstantinos Farsalinos, a cardiologist and research fellow at the Onassis Cardiac Surgery Center in Athens, Greece. Farsalinos found that across 13 studies from China, only 6.5 percent of all hospitalized patients with Covid-19 were smokers whereas 26 percent of the population smokes cigarettes. If smoking made no difference, you would expect a 26 percent representation, according to Satel. “If smoking was harmful [relating to Covid-19] you certainly wouldn’t expect lesser representation,” she said. “So that was very eye-catching. This pattern has since been found in many of the studies. They’re all in the same ballpark … a U.S. study found [the same] … A French study also found similar results.”
Satel explains that the research has shown two ways nicotine could have an impact on Covid-19 with one being more plausible. The first theory is, very basically, that nicotine blocks the entry of the virus into receptor cells. The more plausible theory, however, is that nicotine has a suppressing effect on the cytokine pathway, says Satel. The immune system depends on cytokine signaling to keep the human body healthy.
“Now, cytokines are chemicals produced by white cells in the body or the infection-fighting cells. And specifically, in this case, a macrophage is one of those cells, and macrophages literally eat viruses,” explains Satel. “Anyway, briefly, there is a receptor on the macrophage called the citicoline receptor or a neuronal type, and nicotine also can attach to that receptor and influence the release of those cytokines, and the mechanism of that is called a cytokine storm.”
WHO is to blame?
Tobacco may also be potentially part of a Covid-19 cure. British American Tobacco (BAT) researchers announced in May that BAT’s potential Covid-19 vaccine was moving to human trials after it generated a positive immune response in preclinical trials. The vaccine candidate uses proteins from tobacco leaves. Yet rather than welcoming BAT’s effort to help tackle the pandemic, the WHO cautioned health authorities against engaging with the tobacco industry.
Many experts believe that even if BAT is successful in creating a vaccine, organizations such as the WHO would ignore the science and possibly put lives at risk. It would not be the first time, explains Tim Andrews, executive director for the Taxpayers Protection Alliance, a group that monitors federal spending. He says the WHO has a long history of hostility to alternative nicotine products.
Andrews says that the WHO’s failures “have cost millions of lives,” not just because of the Covid-19 issues but because its track record of trying to prevent the acceptance of reduced-risk tobacco health alternatives has led to more people smoking and more people dying from combustible cigarettes. “The more I looked over the last few years, the more horrified I was by how [the WHO’s] actions are actively harming and not helping public health,” said Andrews.
Since the electronic nicotine-delivery system (ENDS) came to market, the WHO has attempted to block its advance at every turn. As early as 2008, the WHO has stated that it “does not consider [ENDS] to be a legitimate therapy for smokers trying to quit.” Andrews said that as studies started to show that vapor products were “95 percent safer than combustible cigarettes” and ENDS products became accepted by Public Health England (PHE), the WHO had to make a choice: admit failure and accept ENDS as part of tobacco harm reduction plans or ignore science.
“Unfortunately, they have doubled down on their position contrary to all available evidence. And in fact, not only are they now … working towards further restrictions on e-cigarettes, they’re actually going out spreading deliberate misinformation,” says Andrews. “And it seems the more evidence [that] is coming out on the fact that they’re an effective harm reduction tool, the more the WHO is going to try … to call on countries to do large-scale campaigns against them.”
As an example of WHO dishonesty, Andrews pointed to a large-scale social media campaign started by the health body in January suggesting that ENDS can cause lung injuries and increase the risk of heart disease. According to Andrews, there is not a shred of evidence for either claim.
The WHO campaign included statements such as, “The liquid in e-cigarettes can burn skin and rapidly cause nicotine poisoning if absorbed through the skin,” and “The liquid is also highly flammable.” Not a single thing in those sentences is true, according to Andrews. “It is completely 100 percent made up. These aren’t stupid people. They aren’t writing this out of ignorance. This is a deliberate lie. And then you can see all of these people on Twitter responding by taking vape liquid and lighting [it on] fire. It does not light on fire. It does not burn your skin if you get it on your skin. This is blatant misinformation to scare people. And what is the result of this? If people are scared of something that is 95 percent safer than smoking, they will end up sticking to combustible cigarettes, which are much more deadly for them.”
Numerous public health professionals have joined Andrews in criticizing the WHO’s approach to harm reduction. In June, an international group of independent experts with no conflicting links to the tobacco or vapor industry criticized the WHO for its “backward-looking” approach to innovation and new technology, such as vapor products. The experts say they are exasperated by the WHO’s “dogmatic hostility” toward new technology and fear the U.N. health agency will squander the opportunity to avoid millions of premature deaths that will be caused by smoking.
Iowa state Attorney General Tom Miller, who was the first to publicly release the collaborative letter, said the WHO has lost its sense of mission and purpose. “It’s as if the WHO has forgotten what it is there to do—to save lives and reduce disease,” Miller said. “We can do that by helping and encouraging consumers to switch from cigarettes to lower risk products. This means being honest about the much lower risks and by using smarter regulation to make switching more attractive.”
The group criticizing the WHO includes David Abrams of the School of Global Public Health at New York University; Tikki Pangestu, visiting professor of Lee Kuan Yew School of Public Policy at the National University of Singapore; John Britton, professor of epidemiology at the University of Nottingham; Rajesh Sharan of North-Eastern Hill University in Shillong, India; David Sweanor of the Centre for Health Law, Policy and Ethics at the University of Ottawa; and Clive Bates, director of Counterfactual Consulting.
While making no mention of tobacco control policies, U.S. President Donald Trump in late may announced the U.S. would terminate its relationship with the WHO. He said that the U.N. agency failed to adequately respond to the coronavirus because China has “total control” over the global organization. He also said Chinese officials “ignored” their reporting obligations to the WHO and pressured the WHO to mislead the world when the virus was first discovered, according to a story by The Associated Press.
United against vapor
While the WHO does carry a portion of the blame for the misinformation about vapor products, Michelle Minton, senior fellow at the Competitive Enterprise Institute, another libertarian think tank, says the problem isn’t limited to one or more organizations. She believes that public health across the board has been suppressing evidence.
“This is something I’ve been writing about for many years, and I think really what we are seeing is the worst of it expressed at the time when we need our public health institutions to be at their most effective,” said Minton.
A lot of the evidence has been coming out showing that e-cigarettes are far less harmful and extremely effective as a smoking cessation tool, according to Minton. Studies are showing that ENDS are more efficient than other available nicotine-replacement therapies. However, this is not the message disseminated by the FDA.
“In April 2019, the FDA put out a warning … that they had noticed that in 10 years, from 2009 till 2019, there were 35 seizures reported while somebody was using an e-cigarette,” explains Minton. “And given the fact that there are 70,000 people in this country or more, I believe, that have seizure disorders, and a lot of [people] also vape, it would make sense that at one point or another someone [who also vaped] might actually have a seizure. Thirty-five in 10 years is really a minuscule figure. And as far as I can tell, nothing really came of that.”
In August of 2019, a mysterious lung disease began to appear in the U.S. Then, on Sept. 29, 2019, the first case of e-cigarette or vaping-associated lung injury (EVALI) was announced. “These lung injuries, which at first were described by news reporters—who were getting their information from [the] CDC [Centers for Disease Control and Prevention] and [the] FDA—as vaping,” says Minton. “So vaping-associated pulmonary injury, which suddenly by September changed to EVALI. I even asked [the] CDC about what was the choice of the change putting e-cigarettes up front even at that time as the information [was widely known at the time] that it was linked to illicit THC vaporized products on the black market. So vaping was already too broad of a term, and then when New York started reporting that every single one of their patients admitted or tested positive for THC, and then when they went to test the THC products they were using, they all contained vitamin E acetate. That’s when [the] CDC suddenly decided to use the term ‘EVALI,’ emphasizing e-cigarettes.”
The data now shows that many of the lung injuries occurred in people who are too young to legally purchase marijuana products, according to Minton. EVALI also occurred frequently in states that didn’t have legal marijuana. The CDC waited until late-October 2020 to give that information to the public. As late as Nov. 1, the CDC still advised: “Because the specific compound or ingredient causing lung injury is not yet known, and while the investigation continues, persons should consider refraining from the use of all e-cigarette or vaping products.”
The CDC narrative is still that e-cigarettes had something to do with the EVALI outbreak. However, there continues to be zero evidence that nicotine vapor products were ever found culpable in the lung injuries, says Minton, adding that “the messaging is perfect for [the] CDC who wants to continue this [image] of vaping as an epidemic.”
Ultimately, says Minton, organizations like the WHO, FDA and CDC are losing their credibility because of the way the agencies are handling vaping and ignoring the science. “It really damaged their credibility. On the eve of a crisis, a real crisis, where we would have had or we should have been able to rely on the CDC, their credibility took a major hit,” says Minton. “So that’s what we have going on here. It’s bad all around. But, I’m an optimist, so I think that one of the best things that might be able to come out of this is that Congress and other entities take a look at our public health system and try and narrow the focus of some of these agencies, maybe reign them in a little bit, maybe bring them back to talking about actual science.”
Are vapers at a higher risk of contracting Covid-19?
By Maria Verven
While there’s little doubt that a history of smoking poses a higher risk of serious consequences for those who contract Covid-19, the risks are less well known for vapers.
We simply don’t have enough data on Covid-19 and vaping… yet. While e-cigarette use is popular among younger people, it’s much less prevalent among older adults who are more likely to visit a hospital with Covid-19, where data such as age, smoking and/or vaping history as well as underlying health conditions can be captured and examined for trends.
Clearly, a key mitigating factor is the relatively low rate of e-cigarette use. In China, the epicenter of Covid-19, a 2018 survey of 10,233 individuals in five cities found that only 0.9 percent had used e-cigarettes within the past 30 days.
In the U.S., only 1 percent of those over 65 years reported they currently used e-cigarettes of the 32,931 adults who completed the 2016 National Health Interview Survey. Less than 1 percent of adults over age 65 responded “Yes” when asked, “Have you smoked any e-cigarettes or ‘vaped’ in the past week?” in a more recent Gallup Poll conducted last October.
Another issue is that most vapers switched after years of smoking, where the links between Covid severity are much clearer.
Short of any evidence linking e-cigarette use and Covid severity, both the World Health Organization (WHO) and the Food and Drug Administration (FDA) walked back previous unsubstantiated statements that spread fear and confusion and set off alarm bells in the vaping community.
While scientists continue to study the data and come up with hypotheses about who is most at risk of serious Covid consequences, public health agencies are singing the same old song encouraging people to quit both smoking and vaping.
As always, the truth will eventually come to light.
Smoking and Covid-19: clear links
The most recent analysis of data by researchers at the University of California in San Francisco (UCSF) found that smoking significantly worsens Covid-19.
The study, published in the May issue of Nicotine & Tobacco Research, included 11,590 Covid patients hospitalized in China, Korea and the U.S. The researchers found that the risk of more serious consequences and death nearly doubled if the patient was a current or even a former smoker.
Smoking increases the risk and severity of pulmonary infections in general, although until this study, the correlation between smoking and Covid-19 were less clear. However, this data corroborates previous research showing that smokers ran a higher risk of infection and mortality from a different coronavirus, MERS-COV.
The researchers examined 19 peer-reviewed scientific papers published before April 2020 in PubMed. Of the 11,590 patients, around 30 percent of smokers experienced “disease progression” compared with around 18 percent of non-smoking patients.
The WHO warns smokers of the risks of serious Covid-19 consequences in a Q&A on its website: “Available research suggests that smokers are at higher risk of developing severe Covid-19 outcomes and death. Covid-19 is an infectious disease that primarily attacks the lungs. Smoking impairs lung function, making it harder for the body to fight off coronaviruses and other respiratory diseases.”
However, the WHO stops short of warning vapers that they run the same risks: “There is no evidence about the relationship between e-cigarette use and Covid-19.”
FDA stance elicits swift rebuttal
While warning that smoking cigarettes appears to increase the risks of serious complications and consequences from Covid-19, the FDA admits there’s no evidence showing that vapers are at higher risk.
“E-cigarette use can expose the lungs to toxic chemicals, but whether those exposures increase the risk of Covid-19 is not known,” the FDA wrote in an emailed statement to Bloomberg News after the media outlet ran a story on March 27 with the headline, “Vaping could compound health risks tied to virus, FDA says.”
The article evoked a quick response from a large cadre of distinguished doctors, scientists, professors and policy experts from the U.S., Canada, the U.K. and Greece.
Their letter to the FDA severely critiqued its stance on Covid-19 and vaping, and asserted three important points regarding the 12 million vapers and 34 million smokers in the U.S.:
1. Advice should be validated for veracity: “If the federal government is going to provide advice, it should be available via FDA and CDC websites, validated for its veracity and clarity, tested for unintended consequences, and made widely available through recognized and trusted health professionals.”
2. There’s no evidence on vaping and Covid-19: “Many older adult vapers will have underlying conditions… through many years of smoking… that increase their vulnerability and likelihood of severe or fatal Covid-19 symptoms. We know of no relevant and informative evidence on vaping and Covid-19 and the evidence on smoking and Covid-19 is inconclusive and contradictory.”
3. Pronounced differences in risk between smoking and vaping: “We believe that advice to smokers should be consistent with the longstanding public health imperative to quit smoking using whatever methods work, and that includes by switching to vaping.”
In conclusion, the authors wrote, “It is important that the FDA does not assert or imply an equivalence in risk between smoking and vaping.”
Ultimately, they raised two critical questions: “On what basis is the FDA confident that it is right to discourage people with underlying smoking-related conditions from vaping at this time, given the likely alternative for many is a return to smoking?”
And, “Where is the evidence-based reasoning that advising adult smokers against vaping is appropriate for the protection of public health at any time, but especially during this Covid-19 crisis?”
This isn’t the only snafu the agency has faced.
When people started coming down with a mysterious lung illness last summer, it took months for the FDA and the Centers for Disease Control and Prevention (CDC) to finally acknowledge that THC cartridges, most likely tainted with vitamin E acetate were to blame—and not legal e-liquids.
But by the time they finally connected the obvious dots, the damage was already done. News stories that blamed deaths on “vaping” delivered a major setback to the vaping industry, potentially scaring away vapers and anyone even remotely interested in switching to vaping.
In one silver lining, the pandemic prompted the agency to delay its original May 12 deadline for companies to submit their premarket tobacco applications (PMTA) for vaping products until Sept. 9. This could come as a relief for many companies that were scrambling to meet the May deadline, although the postponement is unlikely to help those who weren’t prepared for the original due date.
Credit: Paul Merki
Still a better option
“To date, there is no conclusive and clear data on the effects of electronic cigarettes on cardiovascular and general health, especially from a longitudinal perspective,” wrote the authors of an article on e-cigarettes and cardiovascular risk published December 2019 on the National Institutes of Health website.
“While waiting for more evidence, it seems reasonable to consider electronic cigarettes as a better option when compared with conventional tobacco products, but at the same time it should be fairly obvious that no smoke is better than electronic smoke,” the authors concluded.
There’s even a hypothesis that nicotine, which has anti-inflammatory properties, may benefit patients with Covid-19 by preventing the immune system to overreact.
Konstantinos Farsalinos, a cardiologist, clinical researcher with the Onassis Cardiac Surgery Center in Athens and expert on e-cigarettes, noticed that very few Covid-19 patients hospitalized in China were smokers, even though about half of Chinese men smoke.
In a paper published in May 2020 in the European Respiratory Journal, Farsalinos and his colleagues walked a fine line on the question of whether smoking reduces or increases the risk of contracting Covid-19.
“Through analysis of the pooled prevalence of current smoking across 11 case series determined that current smoking status was significantly lower than expected gender and age-adjusted prevalence in Covid-19 patients,” the authors wrote.
“While we do not dispute that the prevalence of smoking in Covid-19 cases has been surprisingly low across the world, we would echo the World Health Organization’s advice based on emerging evidence that outcomes in Covid-19 are worse in patients who do smoke.”
Difficulties in obtaining vape supplies
At least one thing is known: the chances that e-liquids or devices could transmit Covid-19 are slim to none, according to experts in microbiology and immunology. While the virus may be able to live on surfaces for two to three days, by the time the products arrive in the U.S., the possibility of contamination is virtually nil.
However, it’s already becoming apparent that Covid-19 may interrupt the vaping supply chain, as most of the the world’s vaping and e-cigarette hardware is produced in Shenzhen, China. While larger vaping companies such as JUUL Labs that have facilities in Shenzhen, may be able to weather the storm, small- and medium-size businesses may experience shortages in hardware, coils and other vaping supplies.
The supply chain is only one in a perfect storm of issues surrounding the industry. Many of these issues are coming to a head in the U.S., which continues to ban flavored vaping products, fuel hysteria over teenage vaping and pass prohibition laws in some counties and states.
In January, the Trump Administration announced that it would prohibit the sale of flavored e-cigarette products except tobacco and menthol in the U.S. Fortunately, the new policy applies only to cartridge-based e-cigarette products made by JUUL Labs and other companies, which are more popular with youth. Refillable, tank-style e-cigarette that are primarily sold in age-restricted vape shops are exempt.
And the new policy is less draconian than the original plan, which was to remove all flavored vaping products, even menthol, from the market until they received FDA clearance.
The state of New York recently passed a new measure prohibiting the sale of tobacco and vaping products in pharmacies, banning all online sales, and restricting vape shops from selling anything but tobacco flavored e-liquids.
And while “essential” services such as convenience stores, pharmacies and gas stations have been allowed to remain open during state-wide shutdowns, vape shops have not been allowed to remain open. So it’s much easier to buy traditional cigarettes than e-cigarettes, e-liquids and vaping supplies, much to the chagrin of both vape shop owners and their customers.
Other countries have deemed vape shops as essential even in pandemic hot spots such as Italy and Spain, France and Switzerland. However, the U.K. has also forced vape shops to close, despite their stance that vaping is a safer alternative to smoking.
Life-saving advice
Vaping devices should be in the same category as nicotine replacement products, like patches or gums, maintained Michael Siegel, a Boston University School of Public Health professor with more than 30 years’ experience in tobacco control including two years at the CDC’s Office on Smoking and Health. “It would make sense to treat them in a similar way to pharmacies,” he said.
“While there is no question that smoking puts individuals at greater risk of serious consequences from Covid-19, it is plausible, but not proven yet, that vaping—which can cause mild, acute respiratory irritation and inflammation—could also impair the respiratory system’s ability to fight off Covid-19 infection,” Siegel said.
“However, any impairment caused by vaping is certainly much less than that caused by smoking. Most importantly, our advice to the public does not really change regardless: If you smoke, it is urgent that you quit. If you can’t quit cold turkey or using FDA-approved medications, then switching to vaping is absolutely indicated and could be lifesaving,” Siegel said.
The original “Vaping Vamp,” Maria Verven owns Verve Communications, a PR and marketing firm specializing in the vapor industry.
Vaping is a safer alternative to smoking, according to a Hong Kong health advisory group. The Hong Kong Legislative Council (Legco) has suspended all discussions on a proposed ban on vaping products. Legco says the products provide smokers with safer smoke-free alternatives.
Legco’s Bills Committee on Smoking announced it had ceased discussions over the proposed ban on electronic cigarettes, heat-not-burn tobacco products (HTPs) and other electronic nicotine delivery systems on June 2, according to a press release.
The committee ended its work after nine meetings, including three public hearings, since it was established in March 2019 to tackle the bill that aimed to amend the Smoking Ordinance and impose a blanket ban on vaping or the use of e-cigarettes, HTPs and the likes.
Hong Kong’s vaping ban was strongly opposed by some members of the committee who cited scientific studies showing that e-cigarettes, HTPs and the likes have much lower levels of toxicants compared to combustible cigarettes.IQOSER, a heated tobacco concern group in Hong Kong, said the end of discussions on the proposed ban on HTPs could hopefully bring lawmakers’ attention to the more important task of addressing the smoking problem. “Smoking incidence remains at more than 10 percent in Hong Kong, which means a tenth of our population is exposed to the health risks brought about by toxicants found in tar, the by-product of tobacco smoke,” said Joe Lo of IQOSER, which is also a member of the Coalition of Asia Pacific Tobacco Harm Reduction Advocates (CAPHRA).
“As we have been saying all along, nicotine is not the problem, but the smoke, which is responsible for thousands of deaths globally each day. Unlike combustible tobacco, e-cigarettes and HTPs do not involve combustion or burning, because they only heat tobacco to a certain degree that is not harmful to humans,” said Lo.
Nancy Loucas, Executive Coordinator of CAPHRA, noted that Hong Kong, like Japan and Korea, has a high number of former smokers who have switched to reduced-harm products, such as heat-not-burn (HnB) devices.“It was pleasing to see that some of the officials involved in the process to decide the fate of the products strongly opposed the ban based on science that proves that [HnB devices] have a lower level of toxicants compared to cigarettes, whilst addressing the concerns of creating black market in illicit trade in the products,” Loucas said.
In Hong Kong, many heated tobacco users were forced back to combustible tobacco because of the inability to access the product in the past year, according to Loucas. “Others, with the means, have risked being caught buying through illicit channels. Legislators such as Peter Shui, Raymond Chan and Cheng Chunt-tai, have repeatedly argued that a ban was neither logical nor feasible. More importantly, all three pointed out that adult smokers should not be deprived of the right to choose tobacco harm reduction,” she said.
Asa Ace Saligupta, who runs consumer group ENDS Cigarette Smoke Thailand, said the country should follow the lead of Hong Kong in putting to rest the discussions on vaping ban. “Lifting the ban on e-cigarettes, HTPs and the likes will provide Thai smokers representing more than 20 percent of our population an opportunity to switch to reduced-risk alternatives. At present, nearly 40 percent of Thai males are at risk of suffering from illnesses caused by the smoking epidemic,” he said.
Photo Credits: Timothy S. Donahue
Stephanie Thuesen, director of stakeholder engagement at The Progressive Public Health Alliance, said any restrictive policy on e-cigarettes and HTPs will exacerbate the smoking problem as this will discourage smokers from switching to reduced-risk alternatives. “Tobacco harm reduction should be viewed as a progressive health policy by all countries to put an end to the smoking problem,” she said.
Kulthida Maneechote of SmokeFree4Life campaign asked tobacco harm reduction advocates and vapers to unite against bans and restrictive policies imposed by countries based on alleged lies fed by the World Health Organization to deprive smokers of less harmful alternatives.
“Let us challenge the fallacies and unscientific guidelines being spread by the World Health Organization on electronic cigarettes especially with the upcoming WHO Framework Convention of Tobacco Control (WHO FCTC) in November this year [the convention has since been cancelled for 2020]. If left unchallenged, e-cigarettes might be banned by governments altogether. This will put many smokers at risk of not being able to choose a better alternative,” she said.
President Donald Trump said Friday that the U.S. will be terminating its relationship with the World Health Organization. He said that the UN agency failed to adequately respond to the coronavirus because China has “total control” over the global organization.
He said Chinese officials “ignored” their reporting obligations to the WHO and pressured the WHO to mislead the world when the virus was first discovered, according to an AP story.
He noted that the U.S. contributes about $450 million to the world body while China provides about $40 million.
The U.S. is the largest source of financial support to the WHO and its exit is expected to significantly weaken the organization. Trump said the U.S. would be “redirecting” the money to “other worldwide and deserving urgent global public health needs,” without providing specifics.
The World Health Organization (WHO) has published three reports to inform countries on the current state of scientific knowledge and policy options available for novel tobacco products such as electronic nicotine delivery systems (ENDS), electronic non-nicotine delivery systems (ENNDS) and heated tobacco products (HTPs).
ENDS and ENNDS, commonly known as e-cigarettes, are available in more than 100 countries while HTPs can be bought in about 40 countries.
The WHO insists that many of the new products are harmful to health.
“HTPs expose users to toxic emissions similar to those found in cigarette smoke, many of which can cause cancer, while ENDS on their own are associated with increased risk of cardiovascular diseases and lung disorders and adverse effects on the development of the fetus during pregnancy,” the WHO stated in a press release.
Because of the damaging and addictive nature of these products, the WHO says regulation is crucial to protect populations, particularly youth.
The publication of the briefs coincides with World No Tobacco Day 2020 on May 31. This year’s theme is “protecting youth from industry manipulation and preventing them from nicotine and tobacco use.”
A vaping advocacy group in New Zealand has asked the Ministry of Health to reject information peddled by the World Health Organization (WHO) which inaccurately and negatively reflects on smoke-free nicotine products.
The Aotearoa Vapers Community Advocacy (AVCA) has written to Associate Health Minister, Jenny Salesa, calling for New Zealand’s position to support current global scientific evidence instead, according to an article on scoop.co.nz.
New Zealand’s Ministry of Health is [was] preparing to present at the Ninth Session of the Conference of the Parties (COP9) to the World Health Organisation’s Framework Convention on Tobacco Control (WHO-FCTC) at The Hague, in the Netherlands, this November. However, the conference has now been cancelled due to Covid-19 concerns.
Director of AVCA, Nancy Loucas, says consumers have been effectively excluded by WHO-FCTC so it is entirely up to the Ministry of Health to represent the interests of the New Zealand public.
“We need you to represent our interests based on pragmatic decisions based on current scientific evidence and verified information on the benefits of the reduced risk products.
“There are numerous scientific studies and statistical evidence reports that prove the harms of these products are no more than five percent of the harms of combustible tobacco. Nicotine is no more addictive than caffeine, and hundreds of thousands of smokers worldwide have been successful switching off combustible tobacco using ENDS (electronic nicotine delivery systems), HTPs (heated tobacco products) as well as snus,” AVCA wrote.
Loucas says despite such evidence, the WHO-FCTC continues to issue information, reports and guidance that contains several inaccuracies regarding e-cigarettes. It insists that ENDS and smokeless alternatives do not help smokers quit smoking; are more harmful than combustible tobacco; and that nicotine is equivalent to heroin in terms of addictiveness.
She believes the WHO’s position is being influenced by vested interests that provide funds to the organisation. The ‘WHO Global Report on the Tobacco Epidemic 2019’ and the ‘WHO Q&A detail on E-cigarettes’ were written with and funded by individuals who have a vested financial interest in pharmaceutical nicotine replacement therapies in development, she says.
“This vested interest has coloured the information in order to serve the political and financial interests of Bloomberg Philanthropies and the Gates Foundation who provide nearly half of all the funding for the WHO-FCTC.
“The WHO is lying to you to protect their own financial interests and keep their private donors happy. They are not objective. They are not focused on their own mandate under FCTC to promote the health of the people and their right to have information to make informed choices regarding their health,” AVCA wrote in its letter to Minister Salesa.
AVCA continues to call for New Zealand’s confirmed position on smoke-free nicotine products to be publicly released ahead of the Ministry of Health’s presentation at the WHO’s Framework Convention on Tobacco Control at The Hague later this year.
The World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC) said it would postpone its major conferences for a year.
“In light of the COVID-19 global pandemic and its impact on the conduct of international global conferences and travel, the Bureaus elected by COP8 and MOP1, after consulting the host country, have decided that convening the Ninth Session of the Conference of the Parties to the WHO FCTC (COP9) and the Second Session of the Meeting of the Parties to the Protocol to Eliminate Illicit Trade in Tobacco Products (MOP2), scheduled for November 2020, is no longer possible,” the organization states on its website.
As a result, the Bureaus, in consultation with the host country and the Secretariat, decided during their Third Joint Meeting on 21 April 2020 to postpone the sessions of COP9 and MOP2 to the following dates:
COP9: 8–13 November 2021; .
MOP2: 15–17 November 2021.
The meetings will convene on those dates in The Hague, Netherlands.
U.S. President Donald Trump announced that he is halting funding to the World Health Organization (WHO) during its fight against the coronavirus outbreak.
World leaders condemned this decision.
“It is my belief that the World Health Organization must be supported as it is absolutely critical to the world’s efforts to win the war against Covid-19,” said Antonio Guterres, secretary general of the United Nations.
“Blaming does not help,” Heiko Maas, the German foreign minister, wrote on Twitter. “The virus knows no borders.”
Trump accused the WHO of “severely mismanaging and covering up” the coronavirus outbreak and said the U.S. will withhold funding until it can review the organization’s actions.
The U.S. is the WHO’s biggest donor, and halting funding will deprive the organization of about 10 percent of its budget during the crisis.
IQOSER, a heated tobacco concern group in Hong Kong, said the end of discussions on the proposed ban on HTPs could hopefully bring lawmakers’ attention to the more important task of addressing the smoking problem. “Smoking incidence remains at more than 10 percent in Hong Kong, which means a tenth of our population is exposed to the health risks brought about by toxicants found in tar, the by-product of tobacco smoke,” said Joe Lo of IQOSER, which is also a member of the Coalition of Asia Pacific Tobacco Harm Reduction Advocates (CAPHRA).
“It was pleasing to see that some of the officials involved in the process to decide the fate of the products strongly opposed the ban based on science that proves that [HnB devices] have a lower level of toxicants compared to cigarettes, whilst addressing the concerns of creating black market in illicit trade in the products,” Loucas said.
