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.

Where are the missing verbatim #COP9 reports?

It has been some time since we reported news on #FCTCCOP, but has it been quiet for the FCTC Secretariat?

Silence can mean things are being quietly cooked and indeed, we are back here to report on developments following last year’s secretive COP9. Eventually – almost five months after the meeting – the FCTC Secretariat published the final report of the COP9. The sixty-eight page report reaffirmed the decision taken pre COP that “substantive discussions of and decisions” on some of the agenda items (including articles 9 and 10 and “novel” products) are deferred to COP10, due to be held in Panama in 2023.

However, it is evident there is a lot more in the report than was discussed during the meeting. In particular, FCTC Secretariat has included some suggestions on the regulation of “novel” products – such as the consideration of expanding the definition of “tobacco products” in the Convention to include novel products (page 12) – even though Parties had decided to defer those discussions to COP10.

Last but not least, even the head of the FCTC Secretariat recognised that some discussions literally got lost in translation during COP9 (here). Is this why the verbatim records of the plenary meetings have not been published, as they usually are?

In addition to being shut out from attending the meeting, it seems we are not permitted to know what was said or discussed.

Conference of the Parties Framework Convention on Tobacco Control.