One hundred specialists call for #WHO to change stance on tobacco harm reduction


[1] See, for example: WHO press release for World No Tobacco Day 2021, 19 May 2021 [link]; WHO report on the global tobacco epidemic 2021: addressing new and emerging products, 17 August 2021 [link]; and WHO Q&A on e-cigarettes 29 January 2020 [link]

[2] Balfour DJK, Benowitz NL, Colby SM, Warner KE et al. Balancing Consideration of the Risks and Benefits of E-Cigarettes. Am J Public Health 2021;e1–e12. [link][full text PDF]

[3] Hartmann-Boyce J, McRobbie H, Butler AR, Lindson N, Bullen C, Begh R, et al. Electronic cigarettes for smoking cessation. Cochrane Database Syst Rev. September 2021 update. [link]

[4] The evidence is briefly summarised in: Balfour DJK, Benowitz NL, Colby SM, Warner KE et al. Balancing Consideration of the Risks and Benefits of E-Cigarettes. Am J Public Health 2021;e1–e12. [link]

[5] Palmer AM, Toll BA, Carpenter MJ, et al. Reappraising Choice in Addiction: Novel Conceptualizations and Treatments for Tobacco Use Disorder. Nicotine Tob Res 2021 [link]

[6] By 2030, reduce by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being [compared to 2015] [link]

[7] Bennett JE, Kontis V, Mathers CD, et al. NCD Countdown 2030: pathways to achieving Sustainable Development Goal target 3.4. Lancet 2020;396(10255):918–934. [link] See commentary: NCD Alliance, New NCD Countdown 2030 report shows slow progress towards UN SDG target 3.4, 4 September 2020 [link]

[8] Jha P, Peto R. Global Effects of Smoking, of Quitting, and of Taxing Tobacco. N Engl J Med 2014;370(1):60–68. [link]

[9] See, for example: Mendez D, Warner KE. A Magic Bullet? The Potential Impact of E-Cigarettes on the Toll of Cigarette Smoking. Nicotine Tob Res 2020; [link] and Levy DT, Borland R, Lindblom EN, et al. Potential deaths averted in USA by replacing cigarettes with e-cigarettes. Tob Control 2018;27(1):18–25. [link]

[10] See FDA, Pre-Market Tobacco Marketing Orders, iQOS System Holder and Charger, and Heatsticks, 30 April 2019 [link] and FDA, Modified Risk Orders, iQOS System Holder and Charger, and Heatsticks, 7 July 2020 [link]

[11] Cummings KM, Nahhas GJ, Sweanor DT. What Is Accounting for the Rapid Decline in Cigarette Sales in Japan? Int J Environ Res Public Health 2020;17(10):3570. [link]

[12] Philip Morris International, Can innovative products like IQOS accelerate the decline of smoking? A case study from PMI’s Integrated Report 2020. 18 May 2021 [link]

[13] WHO FCTC/COP/9/9 Comprehensive report on research and evidence on novel and emerging tobacco products, in particular heated tobacco products, in response to paragraphs 2(a)–(d) of decision FCTC/COP8(22) 21 July 2021 [link]

[14] FCTC Convention Secretariat, Challenges posed by and classification of novel and emerging tobacco products, FCTC/COP/9/10, July 2021 [link]

[15] WHO press release: Dr Harsh Vardhan conferred WHO award for leadership in tobacco control. 2 June 2021 [link]

[16] Royal College of Physicians. Nicotine without smoke: tobacco harm reduction. London: RCP; 2016. [link] (12.10 p.187)

[17] Selya AS, Foxon F. Trends in electronic cigarette use and conventional smoking: quantifying a possible ‘diversion’ effect among US adolescents. Addiction. 2021;add.15385. [link]

[18] Sokol N, Feldman J. High school seniors who used e-cigarettes may have otherwise been cigarette smokers: evidence from Monitoring the Future (United States, 2009-2018). Nicotine Tob Res. 2021 [link]

[19] Farsalinos KE, Poulas K, Voudris V, Le Houezec J. E-cigarette use in the European Union: millions of smokers claim e-cigarettes helped them quit [Internet]. Vol. 112, Addiction. Blackwell Publishing Ltd; 2017. p. 545–6. [link]

[20] Friedman AS. A Difference-in-Differences Analysis of Youth Smoking and a Ban on Sales of Flavored Tobacco Products in San Francisco, California. JAMA Pediatr 2021 [link]

[21] Abouk R, Courtemanche C, Feng B, et al. Intended and Unintended Effects of E-cigarette Taxes on Youth Tobacco Use. San Diego State University Center for Health Economics and Policy Studies, Working Paper 2021801: 2021. [link]

[22] Pesko MF, Courtemanche CJ, Maclean JC. The effects of traditional cigarette and e-cigarette tax rates on adult tobacco product use. J Risk Uncertain. 2020;60(3):229–58. [link]

[23] Dave D, Dench D, Grossman M, Kenkel DS, Saffer H. Does e-cigarette advertising encourage adult smokers to quit? J Health Econ. 2019; 68:102227. [link]

[24] Pesko MF, Hughes JM, Faisal FS. The influence of electronic cigarette age purchasing restrictions on adolescent tobacco and marijuana use. Prev Med. 2016;87:207–212. [link]

[25] Jarvis M, Jackson S, West R, Brown J. Epidemic of youth nicotine addiction? What does the National Youth Tobacco Survey 2017-2019 reveal about high school e-cigarette use in the USA? Qeios. 2020. [link]

[26] Glasser AM, Johnson AL, Niaura RS, Abrams DB, Pearson JL. Youth Vaping and Tobacco Use in Context in the United States: Results from the 2018 National Youth Tobacco Survey. Nicotine Tob Res [Internet]. 2021 Feb 16 [cited 2021 Sep 7];23(3):447–53. [link]

[27] Jackson SE, Brown J, Jarvis MJ. Dependence on nicotine in US high school students in the context of changing patterns of tobacco product use. Addiction. 2021;116(7):1859–70. [link]

[28] Levy DT, Warner KE, Michael Cummings K, Hammond D, Kuo C, Fong GT, et al. Examining the relationship of vaping to smoking initiation among US youth and young adults: A reality check. Tob Control. 2019;28(6):629–35. [link]

[29] Meza R, Jimenez-Mendoza E, Levy DT. Trends in Tobacco Use Among Adolescents by Grade, Sex, and Race, 1991-2019. JAMA Netw Open [Internet]. 2020 Dec 1 [cited 2021 Sep 19];3(12):e2027465–e2027465. [link]

[30] Chan GCK, Stjepanović D, Lim C, Sun T, Shanmuga Anandan A, Connor JP, et al. Gateway or common liability? A systematic review and meta-analysis of studies of adolescent e-cigarette use and future smoking initiation . Addiction. 202;add.15246. [link]

[31] Hall W, Chan G. The “gateway” effect of e-cigarettes may be explained by a genetic liability to risk-taking. PLOS Med. 2021;18(3):e1003554. [link]

[32] Kim S, Selya AS. The Relationship Between Electronic Cigarette Use and Conventional Cigarette Smoking Is Largely Attributable to Shared Risk Factors. Nicotine Tob Res. 2020;22(7):1123–30. [link]

[33] Lee PN, Coombs KJ, Afolalu EF. Considerations related to vaping as a possible gateway into cigarette smoking: an analytical review. F1000Research. Version 3, July 2019. [link]

[34] Stanaway JD, Afshin A, Gakidou E, et al. Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet 2018;392(10159):1923–1994. [link]

[35] Kozlowski LT. Policy Makers and Consumers Should Prioritize Human Rights to Being Smoke-Free over Either Tobacco- or Nicotine-Free: Accurate Terms and Relevant Evidence [Internet]. Nicotine Tob. Res. 2020;22(6):1056–1058. [link]

[36] See, for example, Letter to WHO Director General from 72 independent experts in tobacco and nicotine policy, 1 October 2018 [link], and Comments on vaping and tobacco harm reduction from expert stakeholders, 31 May 2021 [link].

[37] See, for example, 14,000+ testimonials at Right to Vape [link]

[38] WHO, Independent evaluation of global COVID-19 response announced, 9 July 2020 [link]