Another anonymously-written WHO paper is misleading Parties to #COP10

The one where it is suggested nicotine pouches should be banned because they are popular

Two weeks ago, Copwatch drew attention to an anonymously-written paper designed to gaslight Parties at COP10 about disposable vapes.

There is a similar attempt at gaslighting going on with a second document in the same series, this time on nicotine pouches. It begins by setting out its stall. “As we will illustrate below, pouches are offered in an extraordinary array of flavours”, before misdirecting Parties as to the threat.

It claims that “Studies have shown that flavoured tobacco products disproportionately attract young people.(12) Flavours promote tobacco use among youthful starters and contribute to the onset of nicotine addiction.(13,14)”

The references are listed and it is clear they have nothing to do with nicotine pouches.

Pouches are not “flavoured tobacco products”. Nor are they e-cigarettes and there is no evidence that they are attracting children. If there was, surely the WHO would be quick to reference research to that effect. Evidently there is none, so some misdirection was required.

Starting with this false premise of a threat to youth, the anonymous authors then spend 19 pages just talking about flavours and colours as if they are inherently a bad thing. At no point is there any balance applied by giving the counterargument that they may attract smokers away from far more dangerous combustible tobacco.

Most of the recommendations derive from the FCTC/COP/10/7 report which we covered here. It claims to cover “technical matters related to Articles 9 and 10 of the WHO FCTC (Regulation of contents and disclosure of tobacco products, including waterpipe, smokeless tobacco and heated tobacco products)” but takes the opportunity – beyond its mandate – to make sweeping recommendations on banning nicotine pouches.

And what evidence do they cite in favour of complete prohibition? The first reason they give is that they are popular. Heaven forbid!

The WHO is also appalled that pouches “have attractive properties, such as appealing flavours, and can be used discreetly without the stigma of smoking.” One would have thought this is a winning combination for an alternative to combustible tobacco, especially as these products are virtually indistinguishable from nicotine gum in terms of health risks. They work in exactly the same way, after all.

Instead, the WHO recommends that countries extend surveillance of these products, and regulate them to “to prevent all forms of marketing”.

They also suggest that countries “regulate non-therapeutic nicotine products in the same manner as products of similar appearance, content and use.” What does this mean, you ask? It means regulating nicotine pouches the same way as snus. And that means, in many countries, prohibition.

Frustratingly, it seems that the EU supports the WHO in making these recommendations, as revealed by MEP Charlie Weimers on social media.

So here we are in the familiar “quit-or-die” territory that the WHO and other tobacco control institutions are so fond of. If they have their way and nicotine pouches are banned despite no currently-known harms to their use, you can either go back to deadly smoking or buy them from the already dubious black market where there are no controls on ingredients and nicotine strength. Where child-friendly packaging is not only heavily prevalent but almost seems obligatory and where it is anyone’s guess who items on sale are made by.

Regulations, by their very nature, are supposed to reduce potential harms in the population. Yet these suggestions by an anonymous author of the nicotine pouches paper, and a WHO panel acting outside its remit, will remove products from the legal market which are significantly safer than smoking, enshrine illegal enterprises as the only supplier of a very simple-to-make product, while also offering protection for sales of combustible tobacco, the most dangerous nicotine delivery option out there.

Copwatch does not know whether this should be described as WHO personnel not thinking things through, or simply not thinking.

Human rights alert at #COP10

The FCTC Secretariat is working behind the scenes to impose a narrow view on human rights and tobacco within the UN system and amongst countries (the Parties to the Convention).

At a recent progress meeting of the UN Non-Communicable Disease Task Force Lynn Gentile from the UN Office of the United Nations High Commissioner for Human Rights emphasised that a ‘Human rights framework is indispensable to how we respond to health challenges such as NCDs and mental health’.

Tobacco was a key theme of the meeting. It was reported that Task Force members had agreed plans for ‘ensuring [a] successful conference and meeting of Parties on the Tobacco Control Framework Convention in Panama..’. This is an example of how UN officials work behind the scenes to influence the outcomes of Convention meetings.

It is also reported that the United Nations Development Programme (UNDP) and the FCTC Convention Secretariat are finalising a set of policy briefs that will provide governments with information about how tobacco control impacts different sectors. These documents will likely be made available at the last minute and are not on the published COP agenda.

Under its current leader Adriana Blanco Marquizo, the Convention Secretariat has anchored  its work across the whole UN system including on human rights. It presents a narrow view of tobacco control to other UN agencies which may have little specialist knowledge about tobacco.

The Secretariat report to COP (FCTC/COP/10/15)  on how human rights intersect with the work of the FCTC is one-sided and thin. It includes statements about protecting individuals from tobacco smoke, mention of the right to life, and mention of the highest attainable state of health and the rights of children and tobacco growers. The Secretariat fails to mention another stream of human rights work within the UN system, in which access to harm reduction resources is a key part of the right to health.  International human rights law supports harm reduction, a case initially made by the UN Special Rapporteur on the Right to Health and now acknowledged by many UN agencies who work on drugs and on HIV harm reduction. Access to safer nicotine products can be seen as part of the right to health in that people should be able to choose safer alternatives to smoking.

As Copwatch has been at pains to point out, tobacco harm reduction (THR) is, so far, absent from COP10. None of the documents nor reports intended to influence the Parties mention that safer nicotine products offer any opportunities for individual and public health. Safer nicotine products are presented as a threat to tobacco control, rather than as having potential to divert people from smoking and other risky tobacco use. 

The COP documents class all tobacco products together, and do not distinguish between high risk tobacco products and safer alternatives. We predict that the narrow human rights perspective proposed by the Secretariat will present safer nicotine products as much of a threat to the right to health as cigarettes. THR consumer advocacy groups are highlighting the right to access safer nicotine products. In an open letter addressed to the UN High Commissioner for Human Rights – Volker Türk – 52 civil society organisations highlight the urgency of adopting strategies based on harm reduction and the right to health (see here for the English version). They ask that the UN system recognises harm reduction as obligatory under the right to health and that he encourages the WHO to recognise the legitimacy of harm reduction in relation to smoking, to encourage states to adopt harm reduction policies, and to encourage the participation of consumer groups at COP. It will be interesting to see the reply.

A vaper’s call to the delegations to #COP10

“I call on the Philippine delegation, and all delegations, to the next FCTC COP, to consider our plight”

Here we publish a powerful plea from a vaper in the Philippines to the delegates who will be meeting at COP10 in Panama next month. 

“In one month, the parties to the Framework Convention on Tobacco Control will meet in Panama to discuss and set rules on how cigarettes and vaporized nicotine products or VNPs (this is how we refer to e-cigarettes and heated tobacco products here in the Philippines) should be regulated. The debate is as political and as emotional as ever. Netflix has this feature documentary on the biggest vape product in the world, the UK is in the news with their new approach to tobacco control, and the anti-smoking (now also anti-vaping) NGOs are front and center in calling for bans or equalizing the regulations for cigarettes and VNPs. The anti-VNP campaign employs alarmist propaganda, fake news, half-truths,and disinformation. Panama will set the tone for the next chapter of the VNP story. 

What is drowned in all this noise are the voices of the people who will be most impacted, smokers and vapers. Smokers because VNPs have proven to be a useful tool for quitting, and vapers who benefit from their availability at present. I am a former smoker. I was able to quit with the help of a VNP. I am still a vaper today, and if the essential qualities that make VNPs work for smokers are taken away (like flavors and nicotine restrictions), I’m not sure if I can keep vaping, or if I’ll find myself going back to cigarettes. This may very well be the case for the millions of vapers globally who will be impacted by the decisions of a handful of bureaucrats in Panama who are not even brave enough to open their discussions to the public eye. 

The problem with this debate is that the antis are pushing the narrative that keeping minors away from VNPs and helping adult smokers quit using VNPs are mutually exclusive approaches. They are not. It is possible to protect minors from getting hooked on nicotine products AND give adult smokers the chance to try these, and for adult vapers, to continue making this their nicotine product of choice. It’s all about the regulation. Banning, or equalizing the regulations, will only favor cigarettes and the black market. It still amazes me how the WHO and the NGOs turn a blind eye on these realities, and how they always argue like things happen in a vacuum. “Vapor products are dangerous; they have this chemical or that chemical” they say. That’s true, but if you compare these with cigarettes, they are much less harmful. This comparative exercise should be the test, and not something buried in the sensationalist headlines that banner the worst possible things you can imagine from this product category (think popcorn lung, EVALI, and other kinds of misinformation) which will not even happen if proper regulations are in place. 

The old traditional tobacco control measures should be supplemented by these new products. What is worth noting is that the countries with the best VNP regulations are all developed ones. We are yet to see these products take-off in a low- or middle-income country. This is where the COP comes in. Instead of asking how we can keep these products from the poorest of the poor smokers, we should find ways to bring these products to them, as the impact of smoking is felt the hardest in the global south. We have a golden opportunity to study the available evidence, look at the regulations that work (and which are killing cigarettes in the countries where they are given the chance to do so) and share this globally as a best practice. 

Stopping smoking CAN include VNPs. I call on the Philippine delegation, and all delegations, to the next FCTC COP, to consider our plight. We are your constituents too, and our welfare, our lives, are more important than the egos, the personalities, and the ideologies that drive the antis in this debate.” 

FCTC budget: nice work if you can get it

Here Copwatch brings you what you need to know about the COP10 documents relating to the FCTC budget. This covers three documents, all posted on the COP10 main documents page:

FCTC/COP/10/17 Proposed Workplan and Budget for the financial period 2024–2025, 

FCTC/COP/10/18 WHO FCTC Investment Fund, and

FCTC/COP/10/19 Rev.1 Payment of Assessed Contributions and measures to reduce Parties in arrears 

The first thing you need to know is that 59 Parties have not paid their contributions. That’s around one third of the FCTC membership. You should also know that the biggest funder of the FCTC is China. As we know, China is also home to the China Tobacco monopoly, the biggest cigarette company in the world.

Second, in the 2024-2025 period, the FCTC plans to spend some 17 million USD in direct expenses, excluding recovery costs (10/19 Rev1).  Almost half of this is for the salaries of WHO bureaucrats. Some 2 million USD out of the 8 million USD budgeted for salaries is expected to be covered by “extra-budgetary” contributions.  It seems likely that the ‘extra-budgetary’ contributions will come from rich donors, who will set the agenda in line with their interests, not the interests of people who smoke or the countries they reside in.

The single biggest non-salary cost, by far, is… the hosting of COP11 at almost 1.7 million USD. Copwatch is confused! In August, it was revealed that there was outrage in Panama at the revelation that the Ministry of Health (Minsa) had spent “$4,881,732.20 for the organisation of a conference against tobacco.” Is this 1.7 million USD in addition to that?

Now, how do you like that as a taxpayer? Given how secretive COPs are, you certainly won’t be able to judge if you are getting value for your money. 

Third, we are guessing that the investment fund launched at COP9 is not doing well. But, we can only guess, as there is nothing written down about that, instead it is promised that “the Convention Secretariat will provide a verbal update at the Tenth session of the COP (COP10) on the status of investment for the Fund.” (10/18). 

These documents reveal that the FCTC has run into another problem – that nobody wants to serve on the two oversight committees (“it was challenging to attract qualified candidates” – see 10/18). One committee was intended to serve the WHO FCTC Investment Fund and the other committee was for the Investment Fund to support the implementation of the Protocol to Eliminate Illicit Trade in Tobacco Products (for which not a single person expressed interest to serve). As a result, the FCTC Secretariat proposes to merge the two committees into one, and will define its purpose, functions, authority, composition and selection, and various other administrative matters.

Here’s the problem with that proposal: the Oversight Committee members are supposed to be proposed by the Selection Committee. Who is the Selection Committee? The President and one Vice-President of the governing body of each treaty, as well as the Head of the Convention Secretariat. In other words, the people with the oversight are appointed by the very same people that they are supposed to oversee. Re-appointment of the Oversight Committee is again up to the Selection Committee.  

But does it really matter? We’re not so sure because the Oversight Committee is purely advisory and has no management, decision-making, or operational responsibility. It need only meet two times per year, and its recommendations can be fully disregarded by the COP and MOP. Finally, in line with the WHO’s ethos of covering things up, the minutes of the Oversight Committee meetings and their recommendations are to be provided to the COP and MOP bureaus only, and not shared with the COP or the MOP, or made public.

In summary:  the FCTC spends almost half of its money on its own salaries. The biggest funder is China, and some salaries are funded by wealthy donors (think Michael Bloomberg). The proposed rules ensure that no meaningful budget oversight will take place in the future. I think that we may have just solved the mystery of what is behind the WHO’s insane war on safer nicotine.

The WHO publishes anonymously-written papers designed to gaslight Parties at COP10

The one where COP delegates are invited to take opinions about vapes on trust

Copwatch has detailed many instances of the WHO and FCTC Secretariat playing fast and loose with evidence or cherry-picking research to suit its anti-harm reduction agenda. It is unscientific and shameful but nothing we have not seen before. But two new reports, on disposable vapes and nicotine pouches, have been published on a separate page to the main COP10 menu which seem specifically designed to mislead COP10 delegates based on nothing more than opinion. 

There is much that could be challenged in them, but the problem would be who to approach considering they are written anonymously. Are senior government officials attending the meeting in Panama from around the world expected to just take the misinformation on trust? 

Let’s discuss the first which concerns single use vapes (which the document charmlessly calls D-ENDS) and contains a number of unreferenced assumptions. 

Without any link to research, it claims that “there is a risk that [the] metal coil will release heavy metals in the heating process.” There may well be a risk, but there also may not. Students are discouraged from referring to Wikipedia for their studies, but at least entries there are rejected if an assumption is not backed up by a credible source. This WHO document does not concern itself with such probity despite being designed for the much more important role of educating government representatives about a vital area of public health. 

It asserts that “the addition of flavourings increases the toxicity of ENDS aerosol in a significant manner”, again without any evidence by way of back up. A Wikipedia reviewer would add [citation needed] but the WHO doesn’t seem to think it necessary. 

The document complains that “we also observe a strong industry lobbying activity to regulate newer products (heated tobacco products, or HTPs, snus and nicotine pouches, and ENDS in all its forms) as little as possible”, which those who recognise the significant benefits of harm reduction would find sensible. Parties are told to ignore this though because – and this may make your jaw drop – the WHO accuses industry of “insisting on rhetoric pretending that they are a “safer” alternative to tobacco products.”

Pretending? There is absolutely no doubt that those products are less harmful than combustible tobacco, with acres of scientific research to support the difference in risk. There is no pretence about it. The only fantasists here are the authors if they believe lower risk nicotine delivery is not safer. If so, how can they be qualified to write papers for the WHO? 

It is also worth noting that consumers and independent scientists are also in favour of light touch regulation, not just industry. Put this down as another flimsy attempt to cast harm reduction as an industry plot rather than a significant public health opportunity. 

It further criticises EU regulations on the strength of nicotine liquids, claiming that 20mg/ml “is already considered a strong concentration” but fails to say by whom. Many would disagree. No reference is given. 

Then the anonymous author or (authors) delve further into cloud cuckoo land. They “stress” that surveys show “D-ENDS prevalence was significantly on the rise and for most other products (HTPs, snus, nicotine pouches) prevalence had increased, and that no significant decrease was observed in cigarette prevalence.” 

Japanese sales of tobacco have declined by around 50% since heated tobacco products hit the market and the UK government recently agreed that vapes “are up to twice as effective as the available licensed nicotine replacement.” One must also wonder how the anonymous authors have missed the fact that Sweden is about to reach the EU smokefree 2040 target of less than 5% smoking prevalence 17 years early thanks to snus use. The WHO document also dreams that “young people could hyperventilate with a D-ENDS”[citation needed], and that “it is usually considered that an Elf bar 800 gives a nicotine equivalent of 60 cigarettes.” This is a regularly-cited snippet of disinformation amongst those opposed to vaping which has been succinctly dismissed as a myth by Action on Smoking and Health in the UK.

After cataloguing red herrings, myths, unsubstantiated opinion and unscientific rumour, our anonymous authors sum up by recommending that “many policies effective against tobacco should be implemented against disposable ENDS as well (plain packages, flavour bans, taxation, full advertisement bans, selling only under a licence system, etc.)”

Copwatch would like to ask a few questions. Who wrote this? What are their qualifications? Why are they offering nothing more than opinions without adequately backing them up with links? Why should Parties believe assertions which are supported by less evidence than would be considered necessary for a half-decent blog? 

The WHO and FCTC Bureau should not be in the business of publishing opinion pieces, which is the only way this document can be described. 

Most importantly, it would be dereliction of duty for Parties to COP10 to take this unevidenced, unprofessional, and superficial guidance seriously when contemplating recommendations in Panama for global regulations.

COP10 documents guide: FCTC/COP/10/4

The one where everyone marks their own homework

Here we continue the Copwatch guide to the documents provided to ‘educate’ national delegations at the COP10 conference in November, with a look at FCTC/COP/10/4

Produced by the Convention Secretariat, the subject for the report is ‘Global progress in implementation of the WHO FCTC’. The report is based on data submitted by the Parties (countries) and measures their progress in implementing the Framework Convention on Tobacco Control Treaty into their national policy and regulatory frameworks.  

The Secretariat defines progress according to how far countries have implemented the FCTC  MPOWER measures, i.e. Monitoring tobacco use, Protecting people from tobacco smoke, Offering help to quit, Warning about dangers of tobacco use, Enforcing bans on tobacco advertising, and Raising taxes on tobacco.

The report notes that implementation of the FCTC has been generally slow.  However, four countries are singled out for praise for adopting the FCTC MPOWER measures to the highest degree —Brazil, Mauritius, the Netherlands and Turkey .  

But, here’s the thing – the adoption of the MPOWER measures is not helping these countries to meet the crucial objective, i.e to reduce smoking.    

In Turkey, the prevalence of smoking is very high and has actually been increasing in recent years.  In  Brazil smoking is declining very slowly, from 10.8% in 2014 to 9.1% in 2021,  Mauritius also shows a tiny decrease from 19.3% in 2015 to 18.1% in 2021The Netherlands, home to a powerful tobacco control lobby, also performs poorly on smoking prevalence rates.   

All four countries, championed by WHO as best practice, perform well on MPOWER measures but perform badly on reducing smoking rates. Is it a coincidence that all four countries have also banned or severely restricted the availability of safer nicotine products?   

In comparison, countries where consumers have been switching to safer nicotine products in large numbers – Japan, New Zealand, Norway, Sweden, the UK – have seen dramatic drops in smoking prevalence.  These successes are not celebrated by WHO. 

Lars M. Ramström, the eminent tobacco control researcher, politely points these uncomfortable truths out in his recent Commentary:

“The measures for Demand Reduction and Supply Reduction recommended by the WHO are certainly valuable tools. But the fight is not maximally effective without the third pillar stated in Article 1d of the FCTC – Harm Reduction.”
[Commentary] The WHO strategies to reduce tobacco-related deaths are insufficient, Lars M. Ramström 

Do read Professor Ramström’s short commentary in full. And, revisit our article from last year, where we reported that Robert Beaglehole and Ruth Bonita, both independent experts with formerly senior roles in WHO, had said much the same thing:

Back to the COP10 official documents – these only confirm that the WHO and FCTC have forgotten about the 1 billion people who smoke, a number unchanged over three decades. WHO and the FCTC secretariat will not be part of the solution while they stubbornly continue with their ineffective MPOWER measures and obstruct tobacco harm reduction.