WHO loves harm reduction – but not for smokers
We had a dream… We had a dream about a comprehensive publication that would highlight best examples of risk reduction policies and approaches in non-communicable diseases (NCDs) and how they could influence tobacco control.
In this dream about NCD best-buys was this recently published WHO report on sodium, which does not call for a ban on salt, even though excessive salt intake causes raised blood pressure and increases risk of cardiovascular disease and is associated with 1.89 million deaths each year. This publication provides policymakers with science-based alternative actions that avoid a prohibitionist approach.
There was another new WHO report in our dream. This one is about road safety. Around 1.3 million people die and millions more are injured or disabled because of road traffic accidents every year. Instead of banning cars, motorcycles, buses, and other vehicles, WHO with partners is calling to adopt policies aiming at increasing use of seatbelts and child restraints. WHO is calling for harm reduction, in other words. In the publication they reminded us of other measures aimed at reducing risks, such as the introduction of speed limits, the creation of safer infrastructure, the enforcement of limits on blood alcohol concentration while driving, and improvements in vehicle safety.
Then our imagination, boosted by R.E.M., moved to publications that would encourage people to drop the most toxic risk factors and replace them with better alternatives. And then this WHO report on the replacement of trans-fatty acids with healthier oils and fats appeared. This provides guidance on finding the best replacement oils for industrially produced Trans Fatty Acids, and on designing and implementing strategies to promote the use of alternatives.
And then we were rudely awakened by a Twitter notification from the FCTC account inviting us to a launch of their new publication. And the spell was broken. Because we already know that we cannot expect a similar harm reduction approach when it comes to tobacco. Yet again, we will hear whining that there are no safer alternatives to smoking, and that tobacco and nicotine products should be banned. Just not the cigarettes.
Why can’t WHO just look at their own examples, as in our dream, and see that their stubborn stance on tobacco just doesn’t make sense?
In the words of Martin Luther King “we must accept finite disappointment, but never lose infinite hope”.