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