UPDATE: The E-cigarette (‘ENDS’) final language
Statement On the Declaration of the 6th Conference of the Parties of the World Health Organisation (WHO) Framework Convention on Tobacco Control (FCTC).
By Professor Gerry Stimson*, Emeritus Professor at Imperial College, London and co-director of Knowledge-Action-Change (KAC)
Saturday, 18 October 2014 (London, UK)
The Conference of the Parties meeting on the WHO Framework Convention on Tobacco Control (FCTC) which took place this week to in Moscow issued a declaration that is unambiguously bad for e-cigarettes, bad for public health and scandously bad for evidence based policy-making
In a meeting tainted by the exclusion of the public and a ban on all media representatives from attending, the WHO FCTC seems unashamedly indifferent to the endemic disregard for evidence and the harmful unintended consequences of the kind of actions that have been agreed in Moscow – the most obvious one being the protecting of conventional cigarettes from competition from far less dangerous products like e-cigarettes.
The ‘Moscow Declaration’ calls for countries to take steps to minimise the proliferation of new nicotine products – which includes the much safer e-cigarettes.
The ultimate irony has successfully managed to take the public out of public health.
The meeting has just got it plain got it wrong because:
It places all its emphasis on minor, hypothetical or imaginary risks and gives no emphasis to the great opportunities that arise from having a popular replacement for smoking with likely 95-100 per cent lower risk than cigarettes.
It seeks to marginalise the industry and innovation behind these products, and encourages forms of regulation – including outright bans on the products and total bans on advertising – that would have the obvious effect of protecting conventional cigarettes from competition from far less dangerous products. If implemented these measures would reduce the likelihood that people will switch to lower risk products and so cause more smoking and disease than would otherwise be the case.
It views electronic nicotine delivery systems (ENDS) as part of the problem, but in reality they are part of the solution – and the widespread uptake of these products is essential if there is to be any hope of meeting the commitment to reducing tobacco consumption by 30 per cent by 2025 (UN commitments on reducing non-communicable disease).
The question needs to be asked – is the WHO capable of getting that particular job done?
* Professor Stimson is a signatory to the letter addressed to WHO Director General Margaret Chan by 53 leading scientists in May 2014 urging the WHO not to treat e-cigarette regulation in the same manner as traditional tobacco.
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About Knowledge-Action-Change
Knowledge-Action-Change is an independent organisation committed to the development and promotion of evidence-based policies and interventions in the field of substance use and related areas of public health and public policy. The organisational ethos is to link knowledge transfer and organisational development to achieve impact at relevant organisational, community, national and international levels.
Update (not part of Professor Stimson’s statement): Position on Electronic Nicotine Delivery Systems evolved (not ‘improved’). Here are relevant texts:
1. The WHO ENDS Report FCTC/COP/6/10 published 26 August 2014. See para 36 for the principles that formed starting point for the final decision. See my critique and open letter and Framework Convention Alliance ENDS position for alternative views of the appropriate principles.
2. The amended version of the WHO ENDS report FCTC/COP/6/10 Rev.1 (significant change at para 52)
3. The Costs Rica proposed wording of a Decision on ENDS 14 Oct 2014
4. An amended version of the Cost Rica proposal for a Decision on ENDS 16 Oct 2014
5, Final language as agreed Decision on ENDS 18 October 2014
Behind closed doors is where corruption likes to hide, brown envelopes are harder to see in dark corners.
It’s also easier to gag those that try to argue, when no one is watching.
The FCTC should be aware that taxing is needed to make countries survive, and every tax has its optimum point of creating revenue. Taxing less then optimum will result in less revenue, but taxing more also since more and more people will start dodging tax all together. That is a basic law of economics. This optimum point is very different in the UK e.g. as in the Philippines, even a child understands. Imposing that optimum point of the tobacco taxation of the western industrialized world to all underdeveloped countries will result to much lesser revenue for the poorest of countries, the poor getting even poorer, having even less money for public health, education,… and costing far more lives than it saves; but WHO cares? On top of that the FCTC states is will actively protect the monopoly of the lethal traditional tobacco industry by banning or at least severely restricting all healthier alternatives to smoking. Phillip Morris and the like can rest and lay back while the WHO does the dirty work of eliminating the competition. This will also cost many lives. Ignoring real science, ignoring real people, excluding press and public while spending huge amounts of public fundings and dismissing every genuine concern by the delegates unavoidably results in a fanatic and dogmatic travesty inspired by ignorance and stupidity… Those so called ‘well doers’ are so severely stuck in a tunnel vision they do much more harm than good and deserve to be feathered and tarred if it were possible. However this does not come as a surprise; the writing was on the wall for decades already.
What baffles me with all these corrupt bodies trying to damage PH, is why haven’t any main stream journalists or news stations even batted an eyelid at these dictates and looked into what’s really going on?
Do I really need get my tinfoil hat on?
If you look deeply into it the mainstream media across the whole world is owned and/or governed by about 10 people. It is these 10 or so people that make all the decisions about what gets media attention and whether its good coverage or bad. Its these people that are part of the problem. They are all in on the politics and dodgy dark room deals that prevent positive things happening in our world.
The W.H.O is incapable of getting any job done properly for the very simple reason that it is in pawn to the leeches who profit only from Ill-Health not Public Health, the Pharmaceutical Multinationals. Until that corrupt connection is slashed through Governments will continue to pay billions for vaccines to control non-existent Pandemics like Avian/Swine ‘flu – what a death-toll they inflicted – while the so-called World Health Organisation wring their hands over Ebola and just blame it on people travelling! The destination they travelled to last week, at a cost of $20 million to the taxpayer for their knees-up, was indeed appropriate. If you want to manipulate the entire world behind closed doors what better place to choose than Moscow. This is an advisory body – anyone who implements this advice is guilty of Genocide on a World scale.
absolutely. I agree with every word you say. You have told it like it is.
Any link to the actual declaration?
This is really sad, it may give total legitimacy to my country’s (Israel) Health Ministry’s proposal to the parliament to ban all e-cigarettes.
I’ve added what I have and I think formed the final text to the top of the post (and here). Of course WHO hasn’t actually published it as far as I can tell, so this is a version from earlier on 18 Oct, the final day, and I assume was agreed.
… and yes, sadly it will lend support to prohibitionists.
WHO has a total lack of fit for purpose.
They have totally got it wrong on Ebola and spend 20 million on this fiasco in Moscow.
WHO is controlled by who?
I would guess that they spend the biggest portion of the income it receives on its own organisation.
Yes the Public in Public health has gone, sold down the swanky for a profit
A loyds risk analyst I met today told me he compared the new cancer cases stats
And they follow an identical, inverse, curve to the uptake of ecigs in the uk.
As he gets paid handsomely by the insurance industry to study these kind of things, I took him very seriously.
Hmmmm… that doesn’t sound likely to be a causal relationship. You would expect several years delay between change of smoking behaviour and incidence of cancer.
He insisted it would show up immediately.
Mark, I’d have to agree with Clive on the causality. The drop in LC rates probably has more to do with a reduction in smoking/asbestos/air-pollution/coal-peat-fires of ten to thirty years ago. Since those things pretty much all decreased during that period, you’d expect to see lung (and other?) cancers go down today… and since e-cig use just happens to be going up today, you’d see an inverse relationship that could falsely be claimed to be causal.
Of course there is *ALSO* the possibility, albeit a very small and totally unrecognized one, that e-cigs could stall or “cure” little lung cancers that would otherwise have grown up to be big, strong, healthy murderers!
– MJM
There was one amusing aspect (if I understand the news correctly) to the WHO declaration on taxation. I believe they called for an international standard tax of 75% on cigarettes.
In New York and in the UK, to name but two locations, I believe a 75% tax rate would cut the cost of cigarettes by considerably more than half!
– MJM
I see they have not forgotten about ENNDS (Electronic NON nicotine delivery systems) to ensure a ‘catch all’ approach for countries like Australia where nicotine sales are already banned.
Bloody hell, they were once the tobacco police, then the nicotine police, now they are the vapour police. Wonder if my kettle falls under this category after all it vapourises a solution – that’s right it’s called water.
Donna, if you boil water, or, even worse, take a shower in a house with other human beings you will be forcing them to inhale hundreds, thousands, or even millions of deadly asbestos fibers in many areas. The “vapor” doesn’t carry them, but there are lots of little dancing microparticles of liquid water that fly into the air and are then inhaled by innocent children and parakeets and kitty cats and fluffy bunnies.
Remember: Love A Hippie! They won’t poison you with the asbestos (or the deadly chlorine gas) from their showers!
;>
MJM
But.. but… don’t “ultrafine” water (H2O) “particles penetrate deeply into the lungs”? Which one .. uhm.. person bleated was the big huge “danger” of e-cigs?
BAN showers! BAN steambaths! And sue my grandma for recommending that I inhale chamomille tea vapor over a bowl as a means to combat bronchitis!
Absolutely bizarre!! I cannot even find the words to describe my thoughts such as a complete bunch of buffoons as this implies a situation or people that has an element of humour attached! Unfortunately, this appears far more sinister. Have people / organisations always been this idiotic and / or corrupt?
I’d propose the following should also be added:
“prevent unproven harm claims being made against ENDS/ENNDS”
Sam, they’ve had a long history of getting away with it on secondhand and thirdhand smoke, so they’re just porting the same techniques over to e-cigs. Try finding a proven harm out there from thirdhand smoke. They’ll rant and rave about babies getting poisoned like the Russian KGB agent from Polonium210, but never mention the tykes would have to lick smokers’ floors for 2.3 trillion years to get that dose.
It’s all a matter of lying by very careful use of language and statistics and study designs so that it becomes very hard to pin someone down in an actual provable falsehood. Remember Bill Clinton and the “It all depends on how you define the word ‘is’ ” defense? Look to the studies on “Smoking bans cause no significant losses to bars AND restaurants.” True enough — as long as you use the word “and” exclusively in the combinatorial sense, ignore the decimation of the bars, and lean heavily on statistical significance in a combination that’s 90% dominated by restaurant outlets. See how easy it is to tell the “truth” and have it actually say the OPPOSITE of the truth?
That’s really all the Antivapers are doing. You just need to concentrate on exposing their lies in ways that people will see them.
– MJM
“.. consider prohibiting… ENDS … taking into account a high level of protection for human health”
Ban the less harmful e-cigs in order to protect human health?
I call that public health malpractice.
What safe guards where in place to prevent insider trading? The press and the public where excluded! The only information available appears to be from leaks. Have the relevant financial regulatory authorities been notified, as the dictates will adversely affect some share prices and boost others substantially.
In order to assure the public that corruption like behaviours are not in evidence it would be useful if the delegates and all those they had contact with in Russia, made their investment portfolios public.
Any doctor who wants to keep youngsters and pregnant women on tobacco out of ‘precaution’ is not fit to tough my body and my health. Honestly any 6 year old has more common sense.
Yes, I quite agree although someone younger than 6 I think would understand! Pregnant women are recommended to use NRT over cigarettes anyway so it is a no brainer. Complete buffoons.
The document should not surprise, after all ENDS are a challenge to a cosy privileged club of ‘experts. The documents most revealing statement is this: “protect tobacco control activities from all commercial and other vested interests related to ENDS/ENNDS” In other words ENDS represents to these authorities a ‘commercial/market based’ threat to their previously unchallenged monopoly over “tobacco control”. It is clear that these authorities, in their secretive meetings, are acting like a cartel, It has nothing to do with public health, it has every thing to do with their privileged status as the only ‘experts’.
,
WHO’s pissed off?!
We the people are the primary stakeholders here. We are not the tobacco industry nor do we represent them. We have been trying to break away from them and we have succeeded with innovative technology….that works. There is no smoking involved. It has been proven and declared by leading scientist and doctors….and even Tobacco activist to be by multitudes safer than smoking tobacco cigarette. Where’s the problem? It’s seem to be within a stigmatized ideology of ” quit or die ” mentality now adopted by the WHO. This is NOT acceptable any longer. Vape safe! Vape LOUD!
Disgusting. Not surprising, given what we know about the WHO, but still disgusting.
I’m disgusted with the WHO and tobacco control in general, as well as most of the “public health” community, not to mention the docile media. They are more concerned about their own positions (funding, power) than they are about the health of those battling the addiction to tobacco. No doubt the EU TPD authors are dancing in the streets and chanting “See – we told you so!”, even though there is STILL no evidence to support their crazy crusade against e-cigs.
Money is the root of most of the evil in the world, including this. The WHO is an incompetent, autocratic, unaccountable, corrupt yet unreasonably influential organisation. It needs to go, or to be completely reinvented.
But no matter who we – the people – vote for, our politicians will not take on the WHO. There is no party prepared to take a stand on this. Our political system has become dysfunctional. I have no doubt that our political masters will follow these recommendations without regard for the consequences to the people they are supposed to represent.
Smokers have been disenfranchised and punished with impunity for some decades. They have been made the target of hatred and lies. And now, those who manage to switch to vaping will be punished for that as well. And the e-cig industry will be put in the black box with the tobacco companies, for no reason related to health.
And the WHO acts to protect itself from any comeback from the industry or the people whose lives it attempts to ruin! What place does such an organisation have in any system of democracy?
I await the outcome of the TW case in the European court with even more interest than before. Is there any justice left in the world??
Last week, Philip Morris International’s 3Q14 report at
http://investors.philipmorrisinternational.com/phoenix.zhtml?c=146476&p=irol-eventDetails&EventId=5170307#
cited competition (and a lack thereof) by e-cigarettes to be a key factor in contrasting changes in quarterly cigarette sales volumes in Italy and Poland.
“In Italy, the total cigarette market of 20.1 billion units decreased by 0.1%, mainly reflecting a lower incidence of e-vapor products and continued growth of the low-price segment.”
“In Poland, the total cigarette market of 11.3 billion units decreased by 10.8%, reflecting the prevalence of e-cigarettes, illicit trade and non-duty paid OTP products.”
When the largest cigarette companies acknowledge that free markets for e-cigs signficantly reduce cigarette consumption, and that excessively regulations on e-cigs prevent cigarette consumption from declining, one would think that those who claim to oppose cigarette smoking would pay attention.
Those are extraordinary figures!
I had a thought. ( remember now, I’m originally a blonde but so is Canada’s leading non-smokers rights activist(Melodie Tilson)
Driving home in the rain from the other side of Nova Scotia ( the Annapolis Valley ) a crazy thought popped in my head.
…….”BREAKING NEWS!! Health y Canada Announces It’s Plans To Embrace The E-Cig.”
In a Precedence setting move Healthy Canadians have announced their intentions to sustain their worldwide leadership concerning standards of health care. After reviewing all the research and well documented studies from doctors and scientists we must concede they ( e-cigs or pv personal vaporizers ) are having a significant positive impact amongst their users. The previously thought of as a phenomenon has stymied healthcare worldwide as the majority of health officials cringed at the thought a new epidemic was evolving while they were still engulfed in scandals fraud, deception and possibly endangering the public’s health when allowing drug producers to set the standards on medications consumed by the public for health care.
The move to announce their intentions on e-cigs ( also known as ends pv’s commonly known as personal vaporizers and favored by users ) by Healthy Canadians was pre-empted when a minority group of Canadians spoke out about Canadian Cancer Societies, Heart and Lung Association and even the World Health Organizations who purposely turned their backs on them. Being highly criticized and stigmatized by these organizations they came forth disclosing the deliberate attack over the years. Those attacks included extreme taxes also known as ” sin tax ” forcing this group to either “pay up” or suffer the consequences. Many have payed in the end with their lives and still do today. Promises of help came at a cost of even more highly priced alternatives that initially failed from the beginning. In addition, this minority group recently stated their intent to disclose how they have been misled by health officials who proclaimed how they cared yet encouraged various drugs of which some literally caused suicidal and aggressive thinking patterns and behaviour to occur while using these drugs. “Insane” is how one group member described it. Little wonder they are coming forth states another Healthy Canadian.
In past history Canada had been known to be a model health care setting for the world to contemplate. The system is based on five founding principles. Care must be universal, portable, comprehensive, accessible, and publicly administered. But does this model of care still prevail? Many think not. Especially those from poorer and ethnic groups.
Not all is lost a spokesperson on behalf of Healthy Canadians states. The decision to embrace these simple yet ingenious advances in technology indicates our revived efforts to change the perceived view of public health professionals. We do care and embracing this tool as a benefit to public health and to the poorer groups that use them to alleviate death and disease; is a step forward we are willing to take. We plan on getting back to our earlier model of universal, portable , compressive and accessible quality of care here in Canada and as leaders for the world to see and follow.
By: Healthy Canadians
Just a note to Health Canada ….. WHO? It’s time to be ACCOUNTABLE!
Fabulous! The press release we will one day see. That day will come?
There is a real unreality-myopic quality to WHO and its associates ambitions for public policy re ENDS.
There are plenty of other bigger real and much more serious challenges for heath policy and budgets – For example Ebola if it is not to become a very serious problem for the whole world will need billions . (And then there are the large ongoing resources needed to combat threats of the ISIS kind and so on.)
The idea that the EU (which is still experiencing negative economic growth)can or should re-direct lots of money and people to regulating and policing a quite small issue :ENDS , one that has little or none threat to non-users health ( at the least) is myopic and bizarre,no?
Is Channing Robertson still involved with WHO policy on ENDS?
Thanks for finally writing about > Professor Gerry Stimson – reaction to WHO FCTC position on e-cigarettes (ENDS)