Time Is Overdue to Rename World No Tobacco Day to World No Cigarette Day

May 31, 2021, is the 34th anniversary of the World Health Organization’s (WHO) World No Tobacco Day (WNTD). This year, the WHO’s WNTD theme is “Commit to Quit.”  It is not surprising that the anti-tobacco zealots at WHO would emphasize “quitting.”  The world has entered a new era in which millions of adult smokers have quit combustible cigarettes by switching to tobacco harm reduction products, including e-cigarettes, heated tobacco products, smokeless, and snus. Unfortunately, as long as  no tobacco holiday is celebrated, there is a concern that many (including the WHO) will continue to not acknowledge tobacco harm reduction, and ultimately fail adult smokers around the world.

The basic fact is that the WHO completely ignores the whole concept of tobacco harm reduction. For example, the Framework Convention on Tobacco Control (FCTC) has missed many opportunities to help people. The FCTC “is the first treaty negotiated under” WHO, and “opened for signature on 16 June to 22 June 2003.” The FCTC currently has 168 signatories, including the European Union. The United States has signed the FCTC but has yet to ratify.  And, as the name implies, it is supposed to support tobacco control.

While WHO claims that the “FCTC is an evidence-based treaty” to reduce tobacco demand, the treaty only promotes policies that are often punishment-based approaches including “price and tax measures to reduce demand,” regulatory measures, and prohibiting “tobacco advertising, promotion and sponsorship.”

In the 44-page FCTC, there is not one single mention of tobacco harm reduction. There is, however, Article 14, which requires signatories to “demand reduction measures concerning tobacco dependence and cessation,” including promoting cessation and providing “adequate treatment for tobacco dependence.”

While mostly associated with e-cigarettes and heated tobacco products, tobacco harm reduction isn’t a new concept. Tobacco companies added filtered cigarettes in the 1950s after health reports began linking cigarette smoking to ill health effects, including cancer. The first filtered cigarette was introduced in 1952 and actually contained asbestos fibers – way worse than the smoke in a cigarette. While filters may not reduce harm, clearly, over half a century ago the notion of reducing the harm associated with smoking was apparent.

Science has come a long way since the 1950s besides just banning smoking on airplanes and practically everywhere else. In 1976, a leading tobacco researcher, Michael Russell, declared that “people smoke for nicotine but die from the tar.”

Tobacco harm reduction products have been around for centuries – namely smokeless tobacco, which remained “the dominant form of tobacco used in the U.S. until early in the 20th century.” Smokeless tobacco includes moist snuff, chewing tobacco, and Swedish and American snus. A 2009 study analyzing “all the epidemiologic evidencing linking smokeless tobacco use and cancer” found “very little evidence” of smokeless tobacco producing elevated cancer risks.

Further, real-life data on the efficacy of snus’ tobacco harm reduction potential comes from Sweden. Swedish men have the highest rate of smokeless tobacco use in Europe, which is directly linked to the lowest smoking rate on the continent. Swedish men also have the lowest rates of lung cancer and other smoking-related diseases in Europe. If men in all other countries of the European Union substituted smokeless tobacco for smoking at the same rates as Swedish men, almost 274,000 deaths per year would be prevented.

Unfortunately, WHO disregards the reduced risk of smokeless and snus tobacco products. According to the WHO’s Scientific Advisory Committee on Tobacco Products Regulation, the benefits of smokeless and snus as a tobacco harm reduction product “have not been demonstrated,” and that ‘there is no evidence to recommend that any smokeless tobacco product should be used as part of a harm reduction strategy.”

E-cigarettes have now emerged as a powerful tobacco harm reduction tool and WHO still continues to denounce their efficacy. FCTC Secretariat Dr. Vera Luiza de Costa e Silva has essentially declared a war on vapor products, claiming they are “a treacherous and flavored camouflage of a health disaster yet to happen if no action is taken now.” 

Despite WHO’s anti-vaping stance, e-cigarettes are not only significantly less harmful than traditional cigarettes, they are also effective at reducing combustible cigarette use. Numerous public health organizations including Public Health England, the Royal College of Physicians and the National Academies of Science, Engineering and Medicine have acknowledged the reduced harm of e-cigarettes. A 2019 report found e-cigarettes to be twice as effective as traditional nicotine replacement therapy in helping smokers quit. And recently, a 2021 study reported a “clear benefit in using e-cigarettes daily in order to quit smoking.”

From airplanes and automobiles to cell phones and hospital technologies,  people have embraced emerging technologies and inventions that improve livesi across the globe. There is no reason why  the same revolutionary advancements in reducing the harm associated with cigarettes and promoting tobacco harm reduction products shouldn’t be embraced. It’s time to drop World No Tobacco Day and replace the holiday with World No Cigarette Day to promote the idea of a commitment to switch from cigarettes to less harmful tobacco and vapor products.