Following on from our last post highlighting how the WHO has been cherry-picking countries to discuss the future of tobacco control in a secret meeting, we now find the
anti-smoking anti-nicotine arm of the WHO cherry-picking information to manipulate the NGO observers to the COP.
Last week,the FCTC Secretariat sent out the email below emphasising a highly dubious review by the Australian National Centre for Epidemiology and Population Health (NCEPH).
Date: Mon, Jun 20, 2022 at 7:15 PM
Subject: Research on e-cigarette use and public health assessment in Australia
Dear NGOs observers to the COP,
The Convention Secretariat and WHO has recently received the visit of Professor Emily Banks, one of Australia’s leading researchers in e-cigarettes and tobacco control. Professor Banks is the Head of the Centre for Public Health Data and Policy, at the National Centre for Epidemiology and Population Health (NCEPH), based at the Australian National University. We would like to share with you information on the last research project she has led in Australia.
The NCEPH conducted a review of the health outcomes in relation to e-cigarette use and a public health assessment of e-cigarettes for Australia, as commissioned by the Australian Department of Health on 27 February 2019. This global systematic review is the most comprehensive review of vaping-related health impacts to date.
To date, at least 32 countries ban the sale of nicotine e-cigarettes, 79 countries – including Australia – allow them to be sold while fully or partially regulating them and the remaining 84 countries do not regulate them at all. In Australia, nicotine e-cigarettes are legal only on prescription, for the purpose of smoking cessation.
In Australia, however, as of 2019, the majority of e-cigarette use is not for smoking cessation, particularly at young ages.
The systematic review of e-cigarettes and health outcomes (Review) published by NCEPH on 7 April 2022 is one of a series of reports produced as part of this project. The Review concludes that:
- There is strong or conclusive evidence that nicotine e-cigarettes can be harmful to health and uncertainty regarding their impacts on a range of important health and disease outcomes.
- The use of nicotine e-cigarettes increases the risk of a range of adverse health outcomes, including: poisoning; toxicity from inhalation (such as seizures); addiction; trauma and burns; lung injury; and smoking uptake, particularly in youth.
- Nicotine e-cigarettes are highly addictive, underpinning increasing and widespread use among children and adolescents in many settings.
- The most common pattern of e-cigarette use is dual e-cigarette use and tobacco smoking, which is generally considered an adverse outcome.
- There is strong evidence that non-smokers who use e-cigarettes are three times as likely to go on to smoke combustible tobacco cigarettes as non-smokers who do not use e-cigarettes, supportive of a “gateway” effect.
- There is limited evidence of efficacy of freebase nicotine e-cigarettes as an aid to smoking cessation in the clinical setting.
The summary brief of the review can be found through this link and the full global systematic review is available here. Additional information about the project and resources from the National Centre for Epidemiology and Population Health are available in this website.
Thank you very much for your attention.
Secretariat of the WHO FCTC
The email repeats conclusions of the review without any objective assessment of the evidence behind them. However, Dr Colin Mendelsohn – member of the Australian Smoking Cessation Guideline Expert Advisory Group who has worked in tobacco treatment for 35 years – has cast a more critical eye on the claims and has noted many debatable, or even false, assertions.
The review claims that there is “conclusive evidence that the use of e-cigarettes can cause respiratory disease (EVALI) among smokers” which is simply not true. Conversely, it declares that there is “limited evidence of efficacy of freebase nicotine e-cigarettes as an aid to smoking cessation” despite the Cochrane living review – the highest quality of scientific evidence – finding that vaping is twice as effective as using NRT for smoking cessation.
The review also carefully picks research suggesting that vaping leads youth to smoking, ignoring real world evidence that the opposite is true. In all states where vaping has been able to compete with combustible products, youth smoking rates have declined considerably since vaping products have been available and are at historically low levels in the UK and USA. Perhaps the FCTC is not aware of what is happening in the world, which would be quite a failing for a global institution, if true.
One wonders why, if Colin Mendelsohn can find so many flaws in the NCEPH evidence, the FCTC Secretariat is incapable of doing the same. Or, if they have done, why the FCTC Secretariat is enthusiastically emphasising the review without a note of caution.
Forgive us for being cynical, but we doubt the FCTC Secretariat sends similar emails to highlight research which shows vaping in a positive light.
To remind you why this is deeply wrong from the Secretariat, please revisit one of our earlier posts – What’s wrong with FCTC COP? The Secretariat should be impartial, but behaviour such as this reveals that it is working to manipulate the Parties according to its own agenda:
It is therefore irresponsible, and arguably ethically wrong, to foment doubt on vaping amongst NGOs and Observers via an official email, without balancing the clearly biased Australian review with the increasingly weighty body of evidence which points to major public health benefits in countries where vaping is leading to impressive declines in smoking.
The FCTC treaty preamble defines its purpose as being to “improve the health of a population by eliminating or reducing their consumption of tobacco products and exposure to tobacco smoke”. Smoke, not nicotine. It seems that the Secretariat has forgotten that.