World Health Organization Continues to Deny Science, Ignores Harm Reduction

The World Health Organization (WHO) recently published its 9th report on tobacco use, titled “WHO report on the global tobacco epidemic.” The report monitors global tobacco use and analyzes the effects of MPOWER, a Michael Bloomberg-backed strategy deployed by the WHO (and other Bloomberg-funded organizations), which includes various measures to reduce tobacco use.

While the WHO is applauding its role in promoting MPOWER strategies, the taxpayer-funded agency is still refusing to accept the role of novel tobacco products in helping to reduce combustible cigarette use. With the 10th annual Conference of the Parties of the Framework Convention for Tobacco Control (FCTC) set to meet in November, it is imperative that members of the FCTC (and all policymakers) ignore the misinformation spewed by the WHO and promote adult access to less harmful alternatives to smoking. 

MPOWER was initially launched in 2008 with funding from Michael Bloomberg to work and created to help members of the FCTC implement the measures of the Convention. From advancing the number of countries with smoke-free laws to increasing taxes on tobacco products, the program promotes various tobacco control measures.

In the recent report, Dr. Tedros Adhanom Ghebreyesus (WHO Director-General) describes MPOWER as providing “cost-effective demand-reduction measures to help countries reduce tobacco consumption.” In Michael Bloomberg’s foreword to the report, the billionaire finds fault that there are too few countries “implementing MPOWER cessation and tobacco taxation policies.”

The effects of MPOWER policies are debatable. The “R” in MPOWER stands for “raise taxes on tobacco” and urges countries to impose excise taxes, valued added taxes and/or import duties.  Yet, cigarette taxes disproportionately harm low-income persons and have failed to reduce smoking rates significantly among lower-income American adults.

More alarming, it’s overly apparent the WHO is continuing to deny the efficacy of tobacco harm reduction. While the “O” in MPOWER stands for “offering help to quit tobacco,” the WHO only monitors “particular tobacco cessation aids,” including nicotine replacement therapy and quit lines.

The WHO defines tobacco control as a “range of supply, demand and harm reduction strategies that aim to improve the health of a population by eliminating or reducing their consumption of tobacco products and exposure to tobacco smoke.”

Yet, in the updated report, the WHO purports that “[n]ew and emerging tobacco nicotine products pose a serious threat to smoke-free measures.” The agency is pushing for a change in the definition of “smoke” to include the aerosols created by novel tobacco products, including heated tobacco products and e-cigarettes.

Further, the WHO claims that heated tobacco products (HTPs) being marketing “with health and cessation claims that are not supported by independent, robust evidence.” The report also claims that e-cigarettes are “targeted specifically at children and young adults” and bemoans the role of flavors. Those claims aren’t true.  In fact, a 2019 review of HTP studies found that compared to cigarettes, modern HTPs “reduced levels of harmful and potentially harmful toxicants by at least 62 percent.” A 2022 Cochrane review found that there was “moderate‐certainty evidence that heated tobacco users have lower exposure to toxicants/carcinogens than cigarette smokers.”

The WHO continues to claim that flavors in e-cigarettes are only meant to attract kids, yet studies indicate adult vapers prefer flavors. And one study has found a greater likelihood in quitting smoking among adults who used flavored e-cigarettes, compared to those who used tobacco flavor.

The WHO is actively urging governments ban e-cigarettes, and in places where they are not banned, they “must be strictly regulated.” Such regulations include taxes, including e-cigarettes and other alternatives to cigarettes in smoke-free bans and banning the sale of all non-tobacco flavors “to reduce the appeal of [e-cigarette] products to children and adolescents.”

Again, the WHO is ignoring the evidence of novel tobacco and vapor products being less harmful and helping adults quit smoking and remain smoke-free.

Government public health agencies from the United Kingdom to New Zealand are promoting the use of e-cigarettes for adults who smoke and are unable or unwilling to quit combustible cigarettes. Another 2022 Cochrane review reported “high certainty evidence that nicotine e-cigarettes are more effective than traditional nicotine-replacement therapy in helping people quit smoking.” The U.S. Food and Drug Administration has authorized the sale of23 e-cigarette products finding their use may be beneficial in helping adults who smoke quit and/or reduce their cigarette consumption.

Unsurprisingly, contributors to the report include other Bloomberg-funded organizations, including Campaign for Tobacco-Free Kids, University of Bath, and Vital Strategies. All these organizations have helped to spread misinformation on tobacco harm reduction and novel products.

It should also be no surprise that even former WHO directors have called out the FCTC’s lack of promoting tobacco harm reduction. In an editorial to The Lancet in 2022, Robert Beaglehole and Ruth Bonita remarked that it was unfortunate that the “WHO and the FCTC Conference of Parties reject harm reduction.” The authors urged the academic journal to “actively endorse harm reduction as a crucial strategy for reducing the burden caused by tobacco,” and for the publication to “add its voice to calls for an independent review of WHO’s tobacco control policies.”

A review of the WHO’s efforts to reduce the burden of cigarettes is welcome. The WHO is continuing a misaligned campaign against less harmful alternatives to cigarettes, which have accelerated significant declines in smoking rates across the globe. Rather than impose draconian restrictions, policymakers must work to ensure adults have access to these lifesaving products.

Lindsey Stroud is Director of the Taxpayers Protection Alliance’s Consumer Center.