WHO fighting a last war against tobacco

Business Reporter

Since the coronavirus pandemic was first detected in December 2019, it has claimed five million lives across the globe. It is staggering.

Perhaps more grimmer are lives lost to one of the world’s silent killers — smoking.

Before the year is out, more than eight million people would have died.

In 1997, the Global Burden on Disease (GBD) study estimated that around three million people were dying annually from smoking and projected a future sharp increase.

It has since come to pass, as mortalities rose to five million by 2002, at which point the World Health Organisation (WHO) estimated deaths would reach eight million by 2030.

“But we are already there,” said Mr Harry Shapiro, the director of DrugWise, an online drug information service, at the recent launch of the Global State of Tobacco Harm Reduction (GSTHR) report.

“So, I think it’s fair to say whatever tobacco controls are in place across the world, they are simply not enough to put a significant dent on these really awful predictions . . .

“In the interest of global public health, a sensible and pragmatic response would be to take seriously the opportunities offered by the advent of safer nicotine products, which now a welter of independent evidence shows they are substantially safer than smoking, they help current smokers both switch away from smoking and offer a safe route to cessation, while at the same time offering little risk to bystanders.

“So, if you actually want to help smokers that’s what you do,” he said.

Yet WHO, which adopted the Framework Convention on Tobacco Control (FCTC) in 2005 to try to promote policies designed to move away from tobacco, has been dithering on actively pushing for alternatives to smoking that have been scientifically proven to be significantly efficacious in reducing smoking-related diseases and deaths.

Over the past 16 years, the emergence of technologically enabled non-combustible nicotine delivery products such as e-cigarettes, vapers and heat-not-burn products, among others, has helped smokers switch to safer products, helping to reduce extreme health outcomes.

According to Mr Shapiro, the WHO, FCTC and its allies, which are bankrolled by anti-tobacco lobbyists, seem to be obsessed with “fighting a last war against tobacco”, even when “there is recognition of failing tobacco-control policies”.

“Billions of smokers are paying the price,” he added.

New trends

Safer nicotine products have been gaining popularity. Since 2006, there are now 100 million users of safer nicotine products, while in the last decade, 75 000 patents have been filed in the area of reduced-risk products.

“Many of them are way upfront. If you have companies like Swedish Match having 40 percent of their revenue from reduced-risk products, PMI (Philip Morris International) is now 30 percent, BAT is at 12 percent, that are pretty good starting point from zero not too long ago,” said Dr David Yach, a global health expert and anti-smoking advocate for more than 30 years.

He previously worked at the WHO, where he was involved in developing the FCTC.

“We never anticipated new technology to accelerate people to quit smoking.”

Governments, he added, should make it easier for companies that produce safer products. On its part, Zimbabwe is mulling a “sin tax” to both finance the health budget and continue fighting non-communicable diseases.

Presenting a position paper on the 2022 Budget at the recent pre-budget seminar in Victoria Falls, Vice President Dr Constantino Chiwenga, who also doubles as Health and Child Care Minister, said: “It is also proposed that a certain number of cigarettes be reserved for financing health; for example, for every five packets sold one goes to the national health services.”

Experts believe public health experts should go further through policies that make safer nicotine products easily accessible and cheaper for consumers, particularly in low-income countries. There is a push for the WHO and other organisations such as the UK Royal College of Physicians and the US Food and Drug Administration — which are considered influential global health bodies — to add their voice to products that have demonstrably shown their ability to reduce smoking-related diseases and death.

Consumers, too, want their sit at the table.

Mr Tom Gleeson, the co-founder of New Nicotine Alliance Ireland, says there are now more than 50 consumer-led organisations promoting harm reduction around the world.

“Tobacco controls total rejection of the tobacco industry has only served to marginalise the development of harm reduction. The industry research on these products is excluded and all that data and evidence is lost to them,” he said.

“Furthermore, without the oversight of those regulatory bodies, there is risk of losing the vital opportunity to reduce harm . . . Tobacco control, to be most effective, must encompass regulators, manufactures and consumers.”

Pressure is increasingly building on the WHO to change direction and tact by taking into account the built-up of scientific data supporting harm reduction in order to save lives.

The stakes are too high.

Experts estimate that smoking-related deaths might top one billion by end of the century.