WHO on e-cigarettes – protecting cigarette sales and causing more disease and death

Original image removed at the request of WHO Legal Counsel

Following publication of WHO’s paper on e-cigs for the FCTC COP-6 meeting in Moscow the statement below went out to media from Professor Gerry Stimson. I agree with all of it, but think he is far too polite.  My initial reaction was as below (Update 15 Sept 2014: a more complete analysis is now available): The new paper is a modest improvement on the extremist position it took to COP-5 in 2012 but it hasn’t stopped them recommending a hugely disproportionate regulatory response based on:

  • exaggeration of minor or implausible risks;
  • selective citation and misrepresentation of science;
  • a confusion of objectives and failure to recognise trade offs between them (is it nicotine addiction or disease?);
  • poor understanding of and apparent indifference to the benefits to smokers and the experience of users;
  • no conceptual framework for harm reduction, relative risk or the role of vaping as a competitor to smoking;
  • no consideration of the ethics of obstructing access or otherwise inhibiting routes to safer nicotine use
  • failure to acknowledge that the purpose of the Framework Convention on Tobacco Control is to regulate tobacco products

Article 3
Objective

The objective of this Convention and its protocols is to protect present and future generations from the devastating health, social, environmental and economic consequences of tobacco consumption and exposure to tobacco smoke by providing a framework for tobacco control measures to be implemented by the Parties at the national, regional and international levels in order to reduce continually and substantially the prevalence of tobacco use and exposure to tobacco smoke

In other words, it has no mandate to be involved in regulation of non-tobacco products.
Updated 4 September, 2014
A strong package of critical commentary and scientific assessment been issued by UK and European scientists.  It is strongly critical of the scientific advice taken by WHO and the negative, and harmful attitude taken by some in public health towards these developments.
End of update.
___________________ Start of Professor Stimson’s statement __________________

Statement on today´s publication of the World Health Orgnisation (WHO) Report on e-cigarettes

By Professor Gerry Stimson*, Emeritus Professor at Imperial College, London and co-director of Knowledge-Action-Change (KAC)

Tuesday, 26 August, 2014 (London, UK)

By Professor Gerry Stimson*, Emeritus Professor at Imperial College London and co-director of Knowledge-Action-Change (KAC)

WHO’s mission is to save lives and prevent disease but once again it is exaggerating the risks of e-cigarettes, while downplaying the huge potential of these non-combustible low risk nicotine products to end the epidemic of tobacco related disease.  WHO claims e-cigarettes are a threat to public health, but this statement has no evidence to support it, and ignores the large number of people who are using them to cut down or quit smoking completely

The WHO recommendations will do more harm than good, ironically protect cigarette sales, and do little to decrease the avoidable burden of non-communicable diseases.

What is needed is light touch regulation and a proper appreciation of trade-offs between regulation to protect consumers whilst not destroying the value these products offer to smokers who want to quit smoking.

The WHO position paper appears to have cherry-picked  the science, used unnecessary scaremongering and misleading  language about the effects of nicotine.

WHO want to regulate these products as either tobacco products or medicines, but in reality they are neither. They do not contain tobacco and they aren’t used for treating or preventing disease.  They are consumer products, and should be governed by consumer protection legislation with specific standards for liquids devices and packaging, and proportionate controls on marketing.  Trying to apply a treaty designed to reduce tobacco consumption is completely inappropriate.

* 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. http://nicotinepolicy.net/documents/letters/MargaretChan.pdf

The WHO report is available at:

http://apps.who.int/gb/fctc/PDF/cop6/FCTC_COP6_10-en.pdf

[contact info]

About Knowledge-Action-Change

Knowledge-Action-Changeisan 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.

www.kachange.eu

31 thoughts on “WHO on e-cigarettes – protecting cigarette sales and causing more disease and death”

  1. One small correction, “WHO want to regulate these products as either tobacco products or medicines” Actually they are suggesting both not either or.
    When you see something as part of the problem and not part of the solution, this is what happens. The question is why are they seen this way, ideology? repulsion at what looks like smoking? or tobacco industry involvement?
    I suspect they in their bubble think the campaign to reduce or eliminate smoking is going well and anything that disrupts the program at this stage is unwelcome no matter how helpful it might be. After all the desired outcome is no more smokers, not healthier people. Allowing smoking behavior undermines the message which they feel has to be pure and simple, they distrust the tobacco industry but distrust the public to choose wisely more.

  2. Yes it does seem to say that:

    Nevertheless, it is likely that a two-pronged regulatory strategy – regulating ENDS as both a tobacco product, in accordance with the provisions of the WHO FCTC, and as a medical product – would be necessary.

    As these two systems are incompatible I just assumed that they meant the approach as promoted in Europe – a twin track. But maybe they want elements of both. For example, medicines for the packaging and tobacco for the marketing?

    1. Clive is is quite possible that the incoherance of their proposal is simply a accurate representation of their ‘thinking’. The regulatory framework they seem to be after will in practice be utterly unworkable. That much is obvious. As for the Chinese would be surprised if they will pay much atentsion to the rules.

  3. Thanks Clive & Gerry for yet again saying it like it is!
    I only wish that my, smoking, non-smoking and vaping (in order to give up nicotine) friends would take the time to read through the obfuscation and follow the money to get to the real reasons why they continue to have doubts.
    I vape because I enjoy it, it harms no-one and I will live longer.

    Keep up the good work.

  4. After reading carefully the TPD-trilog-result, it actual contents already both regulations, tobacco and pharma…they only tried to hide it…hoping the stupid astroturfs will not understand their “wisdom”. I am soooooo sick and tired of their shameless hypocrisy!

  5. Are the WHO (or more correctly the individuals who crafted this shameful document) blind to the evidence, too stupid to understand the evidence, or corrupt? I can’t work out which.

    Review of the science demonstrates that vaping is many orders of magnitude safer than cigarettes. There is no evidence of a gateway effect or of renormalization of smoking. Promotion of vaping to all smokers will reduce morbidity and mortality.

    Plain packaging of cigarettes is already demonstrating that over-regulation can have unwelcome consequences such as a boom in the black market and increased availability of adulterated products.

    Restricting access to vaping and this continued scaremongering will inevitably reduce the number of smokers who adopt this safer alternative, thereby maintaining smoking levels at roughly 20%, thereby continuing to expose children to smoking, thereby ensuring that the consequences of smoking will affect many generations to come.

  6. I’ve read trough the extensive WHO document and in a nutshell:

    (Quote from WHO) “The promotion of ENDS comes with at least one of the following messages or a combination of them: (a) try to quit smoking and if everything fails use ENDS as the last resort; (b) you do not need to quit nicotine addiction, just smoking; and (c) you do not need to quit smoking, use ENDS where you cannot smoke.”

    Against:

    “The promotion of the WHO approach comes with (a) try to quit smoking and if everything fails kill yourselves as the last resort; (b) you do need to quit a harmless nicotine addiction all together, not just the lethal smoking; and (c) you do not need to even bother to quit smoking, since by using ENDS you will be persecuted in the same witch hunt as if you where still a smoker”

    Deside for youserves wich one makes sense.

  7. Surely it is now time for Aspire, Kanger, and all other manufacturers involved in producing these wonderful products, to bring a class action lawsuit against this unelected and unaccountable organization for it’s blatant lies and misrepresentation?

    The WHO has allowed Ebola to spiral out of control while it is busy inciting hatred against Vapers. It is not fit for purpose and should be disbanded.

    1. I fully agree – these companies have been utterly gutless and need to start fighting their regulatory corner. They need to band together and start putting time and money into a serious PR and a decent trade associations. They are just relying on dedicated vapers to do it for them.

      In particular the Chinese manufacturers need to make representations to the Chinese government and inform them that WHO is in the business of destroying an especially valuable export business – in both financial and public health terms.

  8. @Buck Moody
    1000% agree…its already very much overdue!!!
    I really dont understand the behaviour of the industry…no sight no sound
    during all these years where their clients were fighting with teeth and nails!

  9. its a pity…if they would have taken a strong stand at the beginning, a lot of our todays troubles would have been avoided.
    Its always the same…if you dont rule your market, the government will do it for you!

  10. Well, real doctors try to fix the cause, quacks doctor at the symptoms.

    Who addresses the problem?
    WHO prohibits critical voices?

    Case closed. Just bury and forget the victims.

    In former times, doctors WHO failed, often had to deal with enraged friends and family of their victims. Want to see it happen again?

    Here are a lot of friends, who won’t react too complacent to malpractice by you know WHO.

  11. At least one American company is selling eliquid in which the nicotine is extracted from tomato stalks and leaves. This is certainly not a tobacco product. It is clear the WHO is waging war on nicotine unless it is sold as a medicine by a pharmaceutical company. Eventually it will have to admit as much.

    1. Johathan
      Does tomato leaves really contain enough nicotine? If so it really shows up the WHO argument as BS.

  12. The whole conflict of tobacco/pharma/governments stinks to the very root of corruption.
    We vapers all know, and are happy for it to be proven otherwise, that the loss of revenue, be it in gov’t taxation, profits for Big T & P, and the funding for all the ‘do-good’ charities, the NHS Quit, and the likes of ASH are in jeopardy with the success of vaping, and that THIS is the real issue.
    It will never be admitted because that will demonstrate their priorities of money over public health.
    Surely, any mortality of a vaper returning to tobacco due to enforced legislation / restriction is a potential manslaughter or even murder case?

    I quit a 40 a day habit almost 2 years ago using a vaporiser ( hate the term e-cig ) – that’s several thousand pounds in revenue this govt has potentially lost from 1 individual.. and theres over 2 million of me in the uk alone.
    That’s a whole lot of cash to lose, and THEY don’t like it.
    WHO are just being another mouthpiece in the worlds governmental spin to preserve taxes, profits and their own ‘ecclesiastical’ status.
    While we vapers use something that is known to be safer than the killer alternative, they condone EXPERIMENTAL drugs for use in EBOLA… that’s EXPERIMENTAL.. with UNKNOWN effects and outcomes. But then the drug is produced by their Pharma buddies at a massive profit. Hmmmm.

    Clive… keep up the fight. We WILL win.

  13. WHO panel scientist are paid by big pharmaceutical companies.
    Their mission is to ensure more disease = more medicine or vaccine = more money to big pharma.
    Their vision are just figures in their bank.

    Cannabis are banned because pharma co. Can’t patent natural plant.
    Alcohol kills, Cigarette kills – not banned because overdose will end up in rehab, hospital and loads of medical fees. $$$$$
    Cannabis cannot be overdose, URUGUAL will be an alternative medication destination. We’ll wait and see.

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