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.” 

#COP10 documents guide: FCTC/COP/10/9

The one where the WHO tries to redefine smoke and hides inconvenient evidence

To continue the Copwatch guide to documents being provided to ‘educate’ national delegations at the COP10 conference in November, here is a look at FCTC/COP/10/9, published in July. 

This document deals with heated tobacco products but, as we shall see, it is not very impressive. It claims to “examine the challenges that novel and emerging tobacco products are posing for the comprehensive application of the WHO FCTC … as requested in paragraph 3 of decision FCTC/COP8/(22).”

But a quick look at the COP8 decision they refer to shows this does nothing of the sort. In 2018, the WHO asked the FCTC Secretariat:

“to prepare a comprehensive report, with scientists and experts, independent from the tobacco industry, and competent national authorities, to be submitted to the Ninth session of the COP on research and evidence on novel and emerging tobacco products, in particular heated tobacco products, regarding their health impacts including on non-users, their addictive potential, perception and use, attractiveness, potential role in initiating and quitting smoking, marketing including promotional strategies and impacts, claims of reduced harm, variability of products, regulatory experience and monitoring of Parties, impact on tobacco control efforts and research gaps”

Phew, quite a workload! 

The COP8 decision further requested, after that large body of work had been completed, that a report be drawn up to “subsequently propose potential policy options to achieve the objectives and measures” of the FCTC treaty. 

It has been 5 years since COP8 and that decision, but in that time the FCTC Secretariat and their laboratories (known as TobLabNet) appear to have done next to nothing to expand the evidence base. FCTC/COP/10/9 regularly boasts about how very little they know on the subject. 

“Independent … data on the health and environmental impact of these novel tobacco products is incipient” (that’s a posh word for just beginning)

“The knowledge of these novel and emerging tobacco products has been rapidly increasing, but information on their long-term health effects is limited”

“[T]here are limited data available on uptake of HTPs by adolescents, as well as former smokers and non-smokers.” 

It begs the question what, if anything, has the WHO been doing in the last five years since COP8? Countries who have ratified the FCTC treaty do not pay large amounts of taxpayer money for the WHO’s institutions to just sit on their hands for half a decade. Perhaps delegations at COP10 should be asking some searching questions of the Secretariat on the matter. 

Having airily skipped over the yawning chasm of missing research that they were supposed to have gathered on heated tobacco in just four pages, the FCTC/COP/10/9 document then spends the rest of the 18 pages discussing what bans and restrictions should be put in place. Predictably, they demand that heated tobacco should be treated exactly the same as combustible cigarettes, despite HTPs having been found by the UK Committee on Toxicity and the Food and Drug Administration in the United States to be far less harmful than smoking. 

Copwatch also noted the authors of FCTC/COP/10/9 putting on their philosopher’s hat and promoting strange theories of what constitutes smoke. “Can the aerosols of novel and emerging tobacco products qualify as “tobacco smoke?”, they theorize, before answering their own question with a far-fetched explanation. “Yes … strictly speaking, visible aerosols deriving in whole or in part from thermally driven chemical reactions qualify as “smoke”, even when combustion is not involved in the process.”

They are very certain about this, further explaining that “these aerosols are clearly within the scientific definition of “smoke”, and any smoke emitted by HTPs is unambiguously “tobacco smoke.”

The definition of unambiguous is “not open to more than one interpretation” according to Oxford Languages, which will be a surprise to German and Swedish courts who have both found otherwise. 

In September 2021, a decision in a German court struck down the German government’s classification of heated tobacco as “tobacco products for smoking”. A hearing on the merits of a Philip Morris product resulted in the court ordering the Federal Office for Consumer Protection and Food Safety to annul their prior decision and to classify them as “smokeless tobacco products” instead.

A similar case in Sweden in September 2022 came to the same conclusion. The Swedish Public Health Authority (PHA) had decided to classify heated tobacco as “tobacco products for smoking” but was ordered to change this by the court, which held that the PHA’s decision was not in line with any scientific definition of combustion. The court concluded that heated tobacco is not consumed through combustion and “is therefore rightly a smokeless tobacco product.”

Neither the German or Swedish governments appealed the decisions and the definitions are now final and binding in both countries.

Copwatch believes that the WHO is well aware of these court decisions, but just chooses to ignore them. At the foot of the FCTC/COP/10/9 document is an annex which details “several approaches to classify or regulate” heated tobacco in a number of different countries. Note that it says “several” and not all. This is because Germany and Sweden are not amongst them. 

Countries which have ratified the FCTC are allowed to regulate heated tobacco as they wish, smokeless or not, but there are not many cases testing whether the aerosol is smoking or not. In Germany and Sweden there were such cases and the courts decided it is not smoke. 

It would be incredibly inconvenient if the WHO had to admit in its annex that their “unambiguous” definition of smoke is not unambiguous, after all. So they just hide the information from delegates instead. 

To sum up FCTC/COP/10/9, the WHO repeatedly says it does not know much about heated tobacco, but at the same time it is apparent that no work is being done to find out. It recommends treating less harmful products the same as combustible tobacco based on a definition of smoke which is not borne out when tested in court, and it gives the delegations which will be attending COP10 all the information they need to make decisions, except information which the WHO finds inconvenient. 

And we pay for this?

The road to FCTC #COP10

COP10 preparations are advancing when it comes to the FCTC Secretariat. The provisional agenda and some other documents were published earlier this month.

Going from the agenda we can expect a fully packed discussion on substantive items. Readers will remember that COP9 was virtual and that although discussions were tortuous (refresh your memory with our COP live reporting), there was no discussion on ‘substantive items’. This in person COP10 in Panama promises to be a proper bun fight – and we just wonder whether the allotted week will be sufficient. 

We will be analysing the available documentation and will share our thoughts on those with you in the coming weeks. In the meantime, here are some of our quick observations.

The documents already published show we can expect substantive discussions on these subjects: 

  •  Articles 9 (Regulation of the contents of tobacco products) and 10 (Regulation of tobacco product disclosures).  There are  two reports published so far: here and here.  Non-combustible safer alternatives to smoking will be affected.
  • Discussion specifically on ‘novel and emerging tobacco products’, i.e. the safer alternatives to smoking, such as vapes, nicotine pouches, Heated Tobacco Products and snus. 

As you might have already noticed, whilst the Secretariat has been so generous with some documents there are some key pieces of the puzzle that are still outstanding, including:

  • Reports on Articles 9 and 10 (FCTC/COP/10/7),
  • Reports on novel products (FCTC/COP/10/9 and FCTC/COP/10/10),
  • and the draft decisions attached to those.

These missing pieces will show the direction WHO wants to go for alternatives to smoking. Will WHO be dismissing the science behind alternatives to cigarettes yet again? Keep an eye on COPWATCH for analysis and updates. 

And here’s a reminder – should your organisation wish to apply for Observer status please be aware that the deadline to apply is 22 August:

https://fctc.who.int/who-fctc/governance/observers

Do let us know how you get on. 

Yet another murky WHO meeting

Copwatch has often referred to the opaque nature of the WHO’s Conference of the Parties meetings. It is fully expected that the COP10 meeting in Panama will follow the same path of operating behind closed doors, as best described in this briefing from 2021.

“Also excluded are advocacy NGOs representing people directly affected by tobacco control regimes. This includes smokers and users of safer nicotine products. The involvement of the tobacco industry in the production of some but by no means all safer nicotine products means that advocacy organisations in favour of tobacco harm reduction, including numerous vaping or snus consumer advocacy organisations, are excluded de facto.”

The shadowy and forever hidden activities of the Global Tobacco Regulators Forum (GTRF) have also been documented on these pages. Most recently in April

“A small group of researchers, who are not keen on tobacco harm reduction, cherry-picking studies which agree with their preconceived beliefs, and citing unpublished papers from a small selection of WHO members resulting from secret meetings which are not minuted, all funded by a country which is not a Party to the Convention.”

Minutes from the last two FCTC Bureau meetings in November and March have still not surfaced either, as Copwatch has reported before

Now we must add yet another murky WHO meeting to the ever-growing list. 

The UN event management system carries a short notice about an event called the Global Consultation on Novel and Emerging Nicotine and Tobacco Products which is to take place in Geneva between 21 and 23 June. There is no further publicly available information about this meeting. We can assume though that this event is highly likely to be a preparation for COP10 and the work the WHO and the FCTC Secretariat are doing to recommend the full equalisation of all novel products with cigarettes in reports to be presented to the Parties. 

Framed as a consultation, Copwatch expects the result will be dedicated publications, such as these on heated tobacco and vaping products which were issued after a global consultations led by the EURO WHO region before the last COP. 

No-one outside of the WHO FCTC bubble will be allowed to view this latest secret meeting, nor do we expect to see published minutes. 

The WHO website contains a page on transparency, which confidently declares: 

“To build trust, communicators must be transparent about how WHO analyses data and how it makes recommendations and policies.

“Communicators must rapidly and publicly report the participants, processes and conclusions of guideline development meetings.”

Presumably, this is their idea of a joke.

Consumer groups challenging the WHO FCTC – Who will be next?

Now is the time for making our voices heard.

At the beginning of May, Copwatch briefly referenced potential dangers to reduced risk nicotine products at COP10 discussed in recent WHO documents which have been highlighted by the New Nicotine Alliance UK. 

The British consumer organisation launched a call to action in March to encourage “supporters, consumers of reduced risk nicotine products, and others who understand the benefits of harm reduction” to write to their elected representatives and also to the assigned UK focal point to the FCTC Bureau and European region. 

It has started something of a movement. 

In April, four French groups led by consumer association, SoVape, followed suit and began their own similar campaign, declaring that “an offensive against vaping is being prepared ahead of COP10.” A week later, Italian group ANPVU joined the party by inviting Italian consumers to do the same. 

End Cigarette Smoking in Thailand, a consumer association with over 100,000 online followers, also threw their hat in the ring on May 5th, with a press release urging the Thai government and focal point to object to WHO plans to apply bans and restrictions to vaping products at the COP10 meeting in Panama in November. 

Prior to previous COP meetings, the FCTC Secretariat has enjoyed a comfortable ride in producing biassed materials to guide national delegations into hostility towards harm reduction. 

WHO appointees to the FCTC Bureau and Secretariat have always thrived under the cloak of secrecy they cleverly weaved around preparations for COP conferences. They have been mostly unchallenged when ignoring evidence on the effectiveness of safer nicotine and peddling their anti-harm reduction agenda to member delegations. But it appears consumer groups all around the world are alive to their antics this year. 

We are sure that there will be policymakers in the above-mentioned countries finding out for the first time that the WHO is riding roughshod over the concerns of their citizens. With another month or so before delegations form their country positions, messages from the public could be crucial.  

The agenda for COP10 will not be produced until September so there is still time for many other consumer groups to start their own campaigns and we are sure they will. It is becoming quite trendy. 

Speaking truth to power is widely regarded as a virtuous action, but the WHO has been at pains to minimise the risk of this happening with their COP preparations over the years. Engagement with the WHO and their appointed FCTC administrative bureaucracies has been made deliberately impossible, but it is national governments who make the decisions at COP meetings and, unless they are set up as a dictatorship like the WHO, they are beholden to their electorate. 

Copwatch is keen to see which national consumer group will be next out of the blocks to urge their followers to get involved in the COP10 process via the democratic process. Could it be yours? 

If so, time is of the essence. The registration process for submitting national delegations opened on 8 May, so governments will already be thinking about who to send to COP10. The sooner they hear our voices, the better. 

We will be adding the current initiatives to our campaigns tab and look forward to adding more in the near future.

April – victory month for harm reduction

For those valuing a non-dogmatic stance on health issues, one which is rooted in considering the real-life effects of science, and open to contributions from the people most affected – April presented a major success for harm reduction advocates.

For the first time in UN history the notion of harm reduction appeared in the politically negotiated UN resolution on drug policy. Until then harm reduction had only been mentioned in the context of HIV/AIDS. The resolution adopted at the 52nd session of the Human Rights Council mentions a harm reduction approach among other health responses and underlines that support for harm reduction is not qualified as being subject to national legislation.

Furthermore, it seems that including harm reduction in drug control policies is even approved of by the mighty WHO. In a recently published publication the WHO points to the fact that “harm reduction is one of the key elements of a public health promotion framework (or response) that has been proven highly effective in reducing and mitigating the harms of injecting drug use for individuals and communities”.

There is more and more evidence that the so-called “war on drugs” is failing and that new approaches, such as harm reduction, need to be considered. Experts who gathered at the International Harm Reduction Conference in Melbourne in mid-April said that the evidence is in and that it is time for the world to adopt a new approach, one which includes harm reduction solutions. Examples of harm reduction solutions include medically supervised settings for people who inject drugs and decriminalizing drug use.

In the context of the above we would like to point to the fact that the UN resolution, the WHO publication and the experts gathered in Melbourne all recognize the crucial role of civil society and affected communities. Also, that work must be done to involve and engage meaningfully with a diverse representation of civil society and affected communities in their efforts to address all aspects of the world drug problem.

[Hearing this, we allow ourselves a hollow laugh at the recent decisions to reject the participation of nicotine consumer associations in FCTC COP proceedings.]

Setting appropriate, science-based drug policies is extremely important for the affected populations. We can only dream of one day posting a COPWATCH article announcing that FCTC COP recognizes a harm reduction approach in tobacco control, one which includes recognition of the potential of products which reduce harm for people who smoke. 20 years ago the WHO Scientific Advisory Committee on Tobacco Product Regulation stated that “the major acceptable public health rationale for development of new or modified tobacco products is the potential for a reduction in the harm caused by existing tobacco products”. There is now a portfolio of such products, so why have they abandoned harm reduction?

Where are the FCTC Bureau meeting minutes?

It seems that the long march towards a triumphant COP10 later this year must surely have encountered a hitch. The second meeting of the FCTC Bureau took place at the end of November 2022, but here we are at the start of March and the minutes of their last meeting have still not been published. Has their typewriter broken?

The role of the Bureau is to make proposals which are then circulated to regional coordinators. Considering the next Bureau meeting is scheduled for 27-28 March, it does not leave much time to enable the regions to digest what has gone before.

Items at the November meeting would have likely included discussions about the provisional COP10 agenda, requests from parties for elements to be included and maybe details for delegates of the hosting arrangements in Panama. Quite important information.

It is difficult to believe that the regions will not be eager to learn about these matters, so the delay is inconvenient, to say the least.

Or is it that the Bureau is communicating with regions behind the scenes and are reluctant to publish their minutes for the public to see just yet?

We look forward to the typewriter engineers being available to fix this problem soon, and look forward to the belated publication of the Bureau minutes so that the famous WHO FCTC reputation for openness and transparency is protected.

The FCTC is no longer fit for purpose, say independent experts.

As well as reporting the bad news and awful developments, we also try to bring you encouraging news and reasoned views! In response to an article in the Lancet that argues tobacco control is “far from the finish line,” although its measures had an impact worldwide in deterring people from smoking, the independent experts Robert Beaglehole and Ruth Bonita state that “tobacco control is not working for most of the world”. It’s worth noting that both have previously had senior roles at WHO: Ruth Bonita as a former director of the WHO Department of NCD surveillance, and Robert Beaglehole as a former director of the WHO Department of Chronic Disease Prevention and Health Promotion.

In their article, Beaglehole and Bonita report what many in tobacco control think, but only a few will say:

“The FCTC is no longer fit for purpose, especially for low-income countries. Neither WHO nor the FCTC are grounded in the latest evidence on the role of innovative nicotine delivery devices in assisting the transition from cigarettes to much less harmful products.”

Interesting to see how the authors explained why the FCTC is not making progress at the expected pace by providing a simple answer: the missing strategy in WHO and FCTC policies is harm reduction. This might not be news for most of us, but we will repeat it as many times as possible – apparently there are some people who still do not get it or do not want to get it.

Independent research launched at #GFN22 by Dr Lars Ramström shows the WHO’s tobacco control measures, known as MPOWER, are not reducing tobacco-related mortality in Europe. The study reveals that switching from smoking to Swedish-style snus, a safer nicotine product, is a more effective strategy to reduce tobacco-related deaths.

Dr Ramström’s work shows that the WHO must embrace tobacco harm reduction as part of its global tobacco control response by supporting the use of safer nicotine products to quit smoking.

This all accords with the findings of this 2019 study from Hoffman et al, which found “no evidence to indicate that global progress in reducing cigarette consumption has been accelerated by the FCTC treaty mechanism.”

Impact of the WHO Framework Convention on Tobacco Control on global cigarette consumption: quasi-experimental evaluations using interrupted time series analysis and in-sample forecast event modelling
BMJ 2019; 365 doi: https://doi.org/10.1136/bmj.l2287 (Published 19 June 2019)

The last word here goes to Beaglehole and Bonita:

“most people smoke because they are dependent on nicotine. Tobacco harm reduction reduces harm caused by burnt tobacco by replacing cigarettes with much less harmful ways of delivering nicotine; these alternatives have great potential to disrupt the cigarette industry.”

Watch Dr Lars Ramström launching his research here:

Conference of the Parties Framework Convention on Tobacco Control

Knowledge hub surprise!

The term “multilateral” describes the very essence of international treaties and agreements between countries around the world. The Framework Convention on Tobacco Control and COP are no exception and, accordingly, all their discussions and decisions should involve all parties – 182 countries, to be more precise.

On July 5th, the FCTC Secretariat surprised COP watchers by announcing the establishment of a Knowledge Hub, in partnership with Santé Publique France, for education, communication, training and public awareness in tobacco control. This raises some questions! Did the Parties request the establishment of this new Knowledge Hub? Was this discussed at COP9, or at previous COP sessions? Does the FCTC Secretariat have the competence to decide unilaterally when a new KH is needed or with whom it is established – particularly when funding will presumably come from the Parties’ contributions to the FCTC? Was this the wish or commitment of a single Party/Country and is that enough justification to create a new KH? Is this multilateralism?

Once again, the answer to all these questions is NO. In the press release, the FCTC Secretariat vaguely explains that the establishment of this Knowledge Hub “concretizes France’s commitment” to fight against tobacco at the international level. 182 Parties to the FCTC have made this same commitment – but will they all get a Knowledge Hub?

The creation of the KH is also shocking in that it demonstrates that the FCTC Secretariat is using COP to act arbitrarily. The announcement does not accord with the decision taken at COP9 to establish a new Knowledge Hub only upon request (page 43). It also disregards the opinion of one Party that the priority should be a new KH on product regulation (page 15).

FCTC Secretariat is using COP as a facade to act arbitrarily and to take unilateral decisions, without seeking the approval of the Parties.

This unilateral and secretive agreement (publicly announced as a Memorandum of Understanding) also poses questions on how the FCTC is being influenced and driven by the wealthiest countries, to the potential disadvantage of the poorer ones.

Finally, to remind you why this is deeply wrong, we invite you to have a look at the FCTC Secretariat competences, which are clearly very limited and do not authorise the Secretariat to sign agreements with national government agencies, such as Santé Publique France.

We expect the FCTC Parties are also surprised and concerned about this sudden announcement, and that they too will continue to question whether the FCTC is a truly multilateral treaty.

Conference of the Parties Framework Convention on Tobacco Control

Intersessional developments – the secrecy continues

We are now in the intersessional period leading up to COP10 and some developments are worth noting. You might recall that elections of the Bureau for COP10 were held during COP9 last year, with Eswatini becoming Chair and Oman, Netherlands, Uruguay, Sri Lanka, and Australia filling the other committee places. The FCTC website reports that this new Bureau met for the first time during the last week of April. What happened there is somewhat of a mystery. What was discussed? What was agreed? Has any information been shared with the Parties? The answer is we just don’t know. This was yet another secret meeting, driven by the FCTC Secretariat and a cherry-picked group of countries.

The next Bureau meeting is scheduled for the autumn – will we have the same uncanny sensation of being left in the dark after that one too?

Conference of the Parties Framework Convention on Tobacco Control.