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WHO

Uruguay: five key messages from Philip Morris’ failed challenge to packaging laws

31 Aug, 16 | by Marita Hefler, News Editor

Hot on the heels of the tobacco industry’s failed legal challenge to the UK’s tobacco plain packaging laws in May 2016, Philip Morris suffered a new defeat in July, this time in its long-running case against Uruguay’s health warning labels.

The McCabe Centre for Law and Cancer has prepared a paper outlining key aspects of the judgement which are relevant for other governments planning to implement similar legislation to meet their obligations under the World Health Organization Framework Convention on Tobacco Control (FCTC).

The key points explored in detail in the analysis are:

  1. Uruguay’s measures did not substantially deprive Philip Morris of its investments or frustrate any expectations related to those investments
  2. States have a right to regulate in the public interest, including for public health
  3. It is not the role of investment tribunals to second-guess policy decisions, particularly where the evidence is complex or contested
  4. The WHO FCTC and its Guidelines add legal and evidentiary weight in support of states’ tobacco control measures
  5. Public health is an important normative value in investment law adjudication

Full details, including the paper can be found here: http://www.mccabecentre.org/blog/who-fctc-implementation-after-philip-morris-v-uruguay-five-key-messages-from-the-award.html

More analysis:

Industry-funded International Tax and Investment Center responds to criticism by attempting to muddy the waters

24 Jun, 16 | by Marita Hefler, News Editor

Karen A Evans-Reeves, Anna B Gilmore and Andy Rowell

Tobacco Control Research Group, University of Bath,

The tobacco industry is under attack. In just two weeks, in May 2016, its tactic of challenging any law that threatens its profits, took a big hit. The arbitration panel, that tobacco giant Philip Morris International (PMI) had hoped would overturn standardised packaging legislation in Australia, published its full ruling that the company’s self-serving claims were inadmissible. Just days later, all four major tobacco companies lost their challenges against both the European Union’s Tobacco Products Directive and standardised packaging legislation in the UK.

The UK, France and Ireland, which have already enacted standardised packaging legislation, will now go ahead with this brand removal. Further afield Canada, New Zealand, Hungary and Norway are due to follow suit and other countries which have expressed an interest will be buoyed by the way the industry’s legal and trade challenges to plain packs are being soundly rejected. The World Health Organization’s (WHO) slogan for World No Tobacco Day 2016 was “Get Ready for Plain Packaging” recognising that the removal of branded tobacco packaging is “going global.”

Each jurisdiction to consider standardised packaging legislation has received sustained attacks from tobacco companies, using both their own voices and those of third parties which they fund. By commissioning and publicising research reports and opinions from seemingly independent experts, tobacco companies have created not only the impression of a large network of opposition but of an illusory body of evidence, particularly in relation to the industry argument that standardised packaging will increase the illicit tobacco trade.

PMI private documents, leaked to Action on Smoking and Health (UK), revealed that “broad third-party media engagement” and “high profile opinion pieces” would be used to raise awareness of such arguments among “decision makers and the general public” as part of its attempt to prevent standardised packaging in the UK. These documents also revealed that PMI intended to use the International Tax and Investment Centre (ITIC) as one of its key “media messengers”. Since 2012, PMI has paid ITIC (in collaboration with global advisory firm, Oxford Economics) to produce annual reports on the illicit trade in Asia. These claimed that illicit trade is increasing in the region but have been accused of being methodologically flawed. When publicly available routine data was used in an attempt to replicate ITIC’s findings in Hong Kong, illicit levels were found to be under half of what ITIC had estimated.

Key to the industry’s use of third parties is its attempt to shift the paradigm by presenting third parties as ‘independent experts’ and their research as ‘trustworthy and rigorous’ while simultaneously positioning public health academics as ‘advocates’ and ‘zealots’ and their research as ‘advocacy’. This presentation of corporate pawns as informed moderates producing quality work and public health researchers as misguided fundamentalists producing poor quality work is a public relations tactic employed for decades by corporations in relation to environmental and health issues.

Over the last few weeks this tactic has been adopted by the tobacco industry third party, ITIC, in a series of letters sent to Non-Governmental Organisations (South East Asia Tobacco Control Alliance (SEATCA), ASH (UK), EU SmokeFree Partnership), the University of Bath in the UK, and the Editors of Tobacco Control, all of whom had criticised ITIC’s activities, some in letters, reports and webpages. ITIC’s letters made three inter-related claims, each of which we explore in the paragraphs below.

First, that public health research should be seen as advocacy while, by contrast, ITIC’s research (none of which appears to be peer-reviewed) should be seen as high quality. For example, in his letter to the University of Bath the President of ITIC, Daniel Witt, claimed:

We have become increasingly concerned about how the integrity of reputable institutions and individuals is maligned by overzealous advocacy ….. and ….by what passes for academic research when it is clearly constructed to fulfil an advocacy agenda”.

This denigration of public health research has been strongly criticised by independent experts. In her 2006 verdict in an extortion case against the tobacco industry in the United States Judge Gladys Kessler noted:

Much of the Defendants’ [i.e. the tobacco industry’s] criticisms of Government witnesses focused on the fact that these witnesses had been long-time, devoted members of “the public health community.” To suggest that they were presenting inaccurate, untruthful, or unreliable testimony because they had spent their professional lives trying to improve the public health of this country is patently absurd”.

The recent high court ruling on the challenges made by British American Tobacco, PMI, Japan Tobacco International and Imperial Tobacco to UK standardised packaging legislation made a similar point, citing Sir Cyril Chantler’s 2015 review of the evidence:

Chantler … rejected the criticism made by the tobacco companies that those that advised the Government were biased against the industry. Conversely, he articulated scepticism about the methodological efficacy of research results generated by the tobacco companies. He also criticised the tobacco companies for adopting unrealistic criticisms of the output of existing researchers…

This ruling drew upon two peer-reviewed papers, one confirming the poor quality of industry evidence in comparison to public health evidence on standardised packaging and the other paper showing how BAT and JTI  went about distorting and misrepresenting public health evidence.

ITIC’s second claim is that it is not a lobby group. Yet based on widely accepted definitions of lobbying, ITIC’s own descriptions of its activities, and the global health communities’ observations of its behaviour, ITIC clearly acts as a lobbying organisation. Indeed, it has persistently boasted of its lobbying success. in 1995, ITIC produced a document which outlined how “ITIC has developed trusted, advisory relationships with key, senior-level policy makers…..[which]…provide channels for private sector expertise to reach the Government before, during and after the official policy-making process. This combination…… provides ITIC and its sponsors a ‘seat at the policy-making table’”. And in 2004, Daniel Witt, ITIC’s President noted: “ITIC is a public policy organization actively working to change public policy in a pro-investment direction.” Although ITIC claims to be an “independent, non-profit research and educational organization” it receives tobacco company funding and has industry representatives on its Board of Directors.  Outputs such as the Asia-11 and Asia-14 illicit trade indicator studies, commissioned by PMI and published by ITIC along with global advisory firm Oxford Economics, have been critiqued by Dr Hana Ross (on behalf of SEATCA) for opaque methodology and “unverifiable” results that were “inconsistent with results from other studies” in the region (for more on this issue, read here). In 2014, ITIC attempted to destabilise the proposed guidelines on tobacco tax and price policy by convening a meeting with Parties and Observers to the Framework Convention on Tobacco Control (FCTC) immediately prior to the sixth Conference of the Parties (COP6). The Convention’s Secretariat blasted ITIC for this move.

Finally, in each letter, ITIC’s President, Daniel Witt argues that public health organisations ought to engage with ITIC given its tax expertise. This position displays a fundamental misunderstanding of the FCTC’s Article 5.3 which aims to protect policy making from the vested interests of the tobacco industry. It also displays a fundamental lack of understanding of public attitudes to ITIC. For example, the World Bank withdrew from an ITIC event in India, following a letter from the Institute of Public Health in the country,  similarly, following a letter from ASH (UK), the UK Department for International Development (DfiD) asked ITIC to remove its name, from its list of sponsors on ITIC’s website as DfiD has never been a sponsor, and the FCTC Secretariat has urged all governments not to engage with ITIC.

SEATCA and the University of Bath have respectively published and sent to ITIC detailed rebuttals of ITIC’s letters to them. These rebuttals and the aforementioned high court rulings are unlikely to deter ITIC from trying to influence tobacco control policies such as standardised packaging across the globe and undermining Article 5.3 of the FCTC. But the more people who reject engagement with ITIC, the harder it will be for ITIC to boast that it can get its tobacco industry clients a “seat at the policy making table”.

World No Tobacco Day 2016: Get Ready for Plain Packaging

31 May, 16 | by Marita Hefler, News Editor

This year for World No Tobacco Day, the World Health Organization is urging governments to build on advertising and promotion bans by introducing plain packaging of tobacco products.

The measure is the next logical step in stripping away any hint of glamour associated with smoking. It is also an important way of preventing packaging creating misleading suggestions of some tobacco products being less harmful. There is also evidence that plain packaging enhances the impact of graphic health warnings.

Evidence from Australia, the first country in the world to introduce plain packaging, demonstrates the effectiveness. The UK has now introduced plain packaging. Ireland and France have passed plain packaging legislation, and several other countries are set to follow.

Read more:

Tobacco industry attacks WHO, but only incriminates itself

26 Feb, 16 | by Marita Hefler, News Editor

 

Mary Assunta, Southeast Asia Tobacco Control Alliance

The tobacco industry lost the health argument 50 years ago, and in the past decade the WHO Framework Convention on Tobacco Control (FCTC) developed the antidote to reverse the smoking epidemic. However the tobacco industry is stepping up direct attacks, particularly at WHO. Recently the industry took pot shots yet again at WHO and the FCTC Conference of the Parties (COP) in its mouthpiece, Tobacco Reporter. The article, (Snail Mail, Jan 2016) makes several ludicrous accusations against both WHO and the COP but ends up only incriminating itself. We pull quotes from the article and provide our response.

TR: “Most of the besuited classes that turn up at COP7 will have few insights into the lives of the financially impoverished people who tend to make up the world’s smokers.

SEATCA: In reality the tobacco industry has been making billions in profits from selling cigarettes to financially impoverished people all over the world. Eighty percent of the world’s 1.2 billion smokers are in developing countries http://www.who.int/mediacentre/factsheets/fs339/en/. Studies have shown that in the poorest households in many low-income countries, spending on tobacco products often represents more than 10% of total household expenditure http://www.who.int/tobacco/research/economics/rationale/poverty/en/. Don’t forget the famous response from the R.J. Reynolds executive when asked why he didn’t smoke: “We don’t smoke that shit! We just sell it. We reserve the right to smoke for the young, the poor, the black and the stupid.”

TR: “People who turn up at COP7 will almost certainly be well-fed and cossetted

SEATCA: Government officials make up the bulk of the delegates who attend the COP and it seems the industry has no qualms insulting them.

TR: “Wonder whether these smokers really want to trade in what is possibly one of the few enjoyments they have for the few extra years of poverty and struggle …

SEATCA: Most smokers started smoking when they were still minors and did not know any better. Most smokers (70%) want to quit. What the industry refers to flippantly as “few enjoyments” actually leads to illness for many million smokers. Worldwide, about 6 million people die each year , often painfully, because of smoking. This not only affects smokers – it devastates families, emotionally and financially.

TR: “There are far too many people demonizing smokers…

SEATCA: The FCTC does not demonise smokers. It does the reverse to help smokers quit. Smokers are addicted to nicotine and exposed to the thousands of harmful chemical compounds in the product. Two out three of the tobacco industry’s long term customers die prematurely because of their smoking, however the industry continues to push this harmful product. FCTC measures are aimed squarely at the industry, protecting non-smokers and supporting smokers to quit.

TR: “… making decisions about cigarette smoking without understanding it.

SEATCA: There is no misunderstanding because the evidence is in – cigarette smoke contains 7,000 chemical compounds, many of which are carcinogenic.

TR: “People choose to smoke.

SEATCA: Nicotine addiction is not a choice. Most smokers want to quit but find it hard – the addiction is potent displaying similarities to hard drugs such as cocaine and heroin. For decades, the tobacco industry denied or downplayed the harms of tobacco, and it has engineered its products to enhance their addictiveness. It has fought regulations to protect non-smokers from cigarette smoke, restrictions on advertising, and health warnings to inform the public about the danger of smoking.

The WHO is fulfilling its responsibility to support 180 governments’ obligation to implement the FCTC to reduce tobacco use and reverse the smoking epidemic to save lives. An industry that continues to peddle a product that kills has lost the basic concept of humanity.

Shame on the tobacco industry for exploiting the poor and taking pot shots at the WHO and the COP.

 

E-cigarettes and children: advocates walking on both sides of the street?

13 Nov, 15 | by Becky Freeman, Web Editor

Post written by Prof Simon Chapman AO

Follow Simon on Twitter: @simonchapman6

—-

In a 2014 open letter to the WHO’s director general Margaret Chan signed by 53 researchers, it was argued “Controls on [ecigarette] advertising to nonsmokers, and particularly to young people are certainly justified, but a total ban would have many negative effects, including protection of the cigarette market and implicit support for tobacco companies. It is possible to target advertising at existing smokers where the benefits are potentially huge and the risks minimal.”

Clive Bates who “had a hand” in organising the letter but curiously did not sign it, is a former director of England’s Action on Smoking and Health. In that role, Bates directed and wrote one of the most excoriating critiques ever published of the tobacco industry’s long standing (and still running) denials of its designs on children.

In the October 2000 Danger in the Playground, Bates documented many of the most telling examples of candid industry talk about the vital role of children to the future of tobacco industry profitability. This accompanying powerpoint presentation (also authored by Bates) rubs it in even harder. These revelations were all made in internal tobacco industry documents released through the US Master Settlement Agreement between US state governments the tobacco industry, millions of which are now freely available here.

The tobacco industry’s business model about the importance of youth smoking was never put more succinctly than in this 1984 document from an RJ Reynolds tobacco official: “If younger adults turn away from smoking, the industry will decline, just as a population which does not give birth will eventually dwindle.” (“younger adults” was industry code from the mid 1970s for children and young adults, to be used in all written communications)

In a 2000 press statement at the time of the launch of the publication, Bates said “When you look at what they say privately, and compare it to their public posturing, the whole idea that tobacco companies might be working against teenage smoking is revealed as sinister self-serving public relations.  The more they try to define smoking as only for adults, the more they are saying ‘hey kids, smoking’s for grown-ups’ with a sly nod and a cynical wink.”

Today, Bates runs his own consultancy business and is a leading advocate of ecigarettes. Of 220 tweets he posted between Oct 1 and Nov 1, 80% were about ecigarettes. On a recent blog he wrote that when it comes to ecigarettes “There is little evidence of marketing to children, only assertions that certain ads or brands are designed to appeal to children but with no empirical evidence, and apparently minimal understanding of modern advertising.”

On reading this, I was struck by how far Bates appears to have moved in the 15 years since he wrote Danger in the Playground and so tweeted a juxtaposition of the two quotes above, asking “which Clive Bates to believe?”

Bates replied challenging this apparent inconsistency, arguing that his 2000 statement referred to tobacco companies while his 2015 statement referred to ecigarette companies. He argued that currently, the vaping market is worth 100 times less than the cigarette market and that “nearly all vape customers come from the ranks of existing smokers”, which he said explains why adult smokers are the target market for ecigs.

The same analysis can of course be applied to the current contribution of young smokers to the total cigarette market. For example, an early Australian analysis showed that while in one year the value of the underage market to manufacturers was $AUD18.7million, if 50% of young smokers continued to smoke, they would contribute $AUD112 billion at current prices to the industry across their lifetime.

Bates knows perfectly that tobacco companies understand the importance of smoking uptake by children to their future, but seems to believe that such a thought has never crossed the minds of ecig manufacturers.

In an extraordinary statement, he wrote that “there are good reasons why the e-cigarette companies, even tobacco owned ones, would not target adolescents … demand, reputational, legal and regulatory risk etc … it would be bad business.”

flavour

E-cigarettes contain many child-friendly flavors. Flickr/keoni101

This language only needs to be contrasted with the many counterfactual examples he supplied in his own 2000 publication. Yes, there are many good reasons why designs on kids need to be publicly denied. As one 1973 tobacco document describing a supposed anti-youth smoking initiative put it “This is one of the proposals that we shall initiate to show that we as an industry are doing something about discouraging young people to smoke. This of course is a phony way of showing sincerity as we all well know.”

In much the same way as the tobacco industry has long done, many of those promoting vaping are today trying to walk on both sides of the street on youth vaping. They know the reputational risk of openly saying that they are unconcerned about youth uptake. Whenever data show negligible uptake by youth, this is rapidly megaphoned as self-evidently a good thing. But when data show significant use, they try to spin this as being an entirely positive development where it happens: all children who are now vaping would have been smoking instead, these clairvoyants assure us.

In the USA today data from the US National Youth Tobacco Survey show that while cigarette smoking continues to fall in US teenagers, e-cigarette use has been dramatically increasing since 2011 and is now way ahead of cigarette smoking: there are now some 50% more middle and high school kids vaping than are smoking, with an estimated 340,000 vaping on more than 20 days each month. Advertising like this, and 3 year old birthday party favourite flavours like these which Bates thinks should be allowed, are plainly intended to beguile teenagers.

A recent systematic review in the Lancet of nicotine and psychosis concluded that “Daily tobacco use is associated with increased risk of psychosis and an earlier age at onset of psychotic illness. The possibility of a causal link between tobacco use and psychosis merits further examination.” It set out important arguments about why the “self-medication” hypothesis about nicotine (promoted by the tobacco industry) deserves reassessment against one where nicotine might be causative in psychosis. Such serious considerations demand that trite dismissals of nicotine as being as benign as “like drinking coffee or something” be condemned.

Clive Bates and others who signed his letter might like to comment on how “it is possible to target [ecigarette] advertising at existing smokers”; how many of these allegedly “adult targeted” ads would never attract the interest of non-smoking teens; and where parents can buy one of the miraculous magic filters that let such advertising through to smokers but somehow render it invisible or uninteresting to young non-smokers.

The problem with comparing meat and smoking cancer risk

26 Oct, 15 | by Becky Freeman, Web Editor

The Guardian reports:

Comparing meat to tobacco, as most news organisations who’ve chosen to report this have done, makes it seem like a bacon sandwich might be just as harmful as a cigarette. This is absolutely not the case.

 

This Cancer Research UK infographic elegantly shows that while the evidence that processed meat causes cancer is as strong as for tobacco, the RISK from smoking is so much higher:

(click to enlarge image)

infograph

 

World Conference on Tobacco or Health: keeping the focus on the tobacco industry

1 Apr, 15 | by Marita Hefler, News Editor

 

Anna Nicholson, Menzies School of Health Research

Follow Anna on Twitter @annaknicholson

The 16th World Conference on Tobacco or Health (WCTOH) was held in Abu Dhabi from March 17-21 2015, the first time it has been held in the Middle East. While this did not come without challenges (approximately 60 delegates, the majority from Bangladesh, were denied visas – see http://blogs.bmj.com/tc/2015/03/17/15th-world-conference-on-tobacco-or-health-regional-delegates-refused-visas/), the conference was attended by 2,184 delegates from over 100 countries. In the opening plenary, Dr Margaret Chan, Director General of the World Health Organization (WHO), rallied delegates to “keep the battle lines fresh and vigorous”, setting the tone for a program that focused on curtailing the tobacco industry. Despite many successes, delegates were sobered by the record profits recorded by a number of tobacco companies since the 15th WCTOH in 2012, notably in low income countries.

It is 10 years since the WHO FCTC came into force. So where are we now? Of the 178 countries with available data, about two thirds (125) show declining prevalence, but fewer than one in five (37) countries are on track to meet a 30% reduction by 2025. Country-specific surveillance shows 45 countries have comprehensive smoke free policies, 21 have adequate cessation support, 30 have graphic warning labels (>50% of pack), 24 have total advertising & promotion bans, and 32 have adequate taxation (75% of retail price). Day one of the scientific program focussed on growing evidence of the role of MPOWER, the technical package of technical measures and resources to achieve demand reduction provisions of the FCTC (Monitor tobacco use and prevention policies; Protect people from tobacco smoke, Offer help to quit tobacco use, Warn about the dangers of tobacco, Enforce bans on tobacco advertising, promotion and sponsorship, Raise taxes on tobacco).

The conference theme was ‘Tobacco and Non-Communicable Diseases’ (NCDs). It was refreshing to be reminded of the importance to think beyond tobacco, and hear shared learnings from countering food, beverage and alcohol marketing. Delegates were urged to consider strategies that shift responsibility from the individual to industry and government, including product regulation, hard-hitting and sustained campaigns that raise public awareness, and advertising, promotion and sponsorship bans. Underpinning discussions was an awareness that funding available for preventing cardiovascular and other non-communicable diseases is in no way reflective of the scale of the NCD epidemic. Delegates heard about progress toward the World Health Assembly target to reduce tobacco use by 30% as part of the 25×25 global target of a 25% reduction in NCD deaths by 2025, and advocacy efforts to integrate the FCTC with the UN Sustainable Development Goals (SDGs).

The social, economic and environmental impacts of the tobacco industry were also acknowledged: issues such as food and water insecurity, air pollution, deforestation and pesticide use, as well as trade, farming and poverty. Delegates were urged to speak out against these tobacco-related inequalities. A number of symposia featured the heavy burden on low and middle income countries, with a particular focus on ‘best buy’ tobacco control strategies.

Attention was also drawn to many countries failing to provide adequate financial resources to tackle implementation of the FCTC (including high income countries), and the importance of keeping tobacco control efforts free of industry funding and influence. At a national level, delegates heard of the importance of strengthening primary health care systems, improving alliances, and advancing the role of these systems as agents for social change. The role and importance of civil society was also acknowledged, and delegates were encouraged to extend their partnerships and role as tobacco control advocates by including new champions for health reform.

Plain packaging was the focus of one plenary and a number of symposia. Nathan Smyth from the Australian Department of Health welcomed Ireland and the UK, which have both recently voted to introduce plain packaging, to “the greatest fight on Earth”. There was much discussion of lessons learned from current legal battles against the tobacco industry, which aims to slow the diffusion of plain packs by tying up resources, increasing the costs, and countering the evidence base. It was heartening to see the growing number of nations who have plain packaging in their sights despite these battles.

Lack of an evidence base was a key argument the tobacco industry used to fight Australia when it became the first country to introduce plain packs in 2012. Professor Melanie Wakefield used the analogy of a train leaving the station, collecting evidence from stops en route to the destination of reduced prevalence. Hot off the press of the April 2015 Tobacco Control supplement on plain packs, Professor Wakefield, Dr Michelle Scollo and other Australian researchers shared their ‘en route’ findings of the benefits of plain packs to reduce appeal and brand differentiation, focus attention on warning labels and reduce the ability to mislead consumers. Several presentations discussed the influence of pack shape and branding on consumer interpretations of attractiveness and harm, particularly for slim varieties, further highlighting the usefulness of standardised packaging. Delegates were also reminded of the synergistic effects of policies. Plain packs are not a magic bullet; rather they work together with complementary policies such as total bans on other forms of tobacco industry advertising and promotion. (For more about the supplement and the implications of the research findings, see http://blogs.bmj.com/tc/2015/03/18/blockbuster-special-issue-evaluation-of-the-australian-tobacco-plain-packaging-policy/).

Perhaps the most divisive debate was whether e-cigarettes should be viewed as a friend or foe of tobacco control. While the WHO urged caution, presenters in other symposia challenged the need for tight regulation, arguing this may stifle the emergence of potentially safer technologies. Experts appeared unanimous in their agreement that e-cigarettes produce metabolites known to cause disease such as lung cancer, emphysema, pulmonary fibrosis and cardiovascular events. However, the harm is greatly reduced compared to combustible cigarettes, and may be reduced further in new generations of e-cigarettes, particularly if new technologies can eliminate heating altogether. Delegates learned that some youth are using e-cigarettes before smoking cigarettes; however, no strong evidence of a “gateway effect” was reported. Nonetheless, delegates and presenters voiced concern over the appeal of flavours, the need to ban sales to minors, and the need to monitor effects of vaping in public. Given that e-cigarettes are an increasingly popular form of cessation assistance, the issue of how to best regulate them presents a pressing challenge. Professor Ken Warner reminded delegates to keep the focus on evidence-based tobacco control, look to more enlightened regulation (that does not discourage innovation) and continue to reduce the attractiveness of combustible cigarettes.

After four days of stimulating science, the conference ended with a rousing vision from the youth pre-conference delegation on their campaign “No More Tobacco in the 21st Century” (#NMT21C on Twitter), the prioritisation of which featured in one of the conference resolutions. Other conference resolutions centred on the FCTC: increasing signatories, achieving its recognition in the SDGs, and targets towards additional specific measures. There were also resolutions to treat tobacco uniquely in trade agreements, strengthen the Protocol to Eliminate Illicit Trade in Tobacco Products, and for a UN high level meeting to address the threat to humanity caused by the tobacco industry. Interestingly, despite the discussions and presentations throughout the conference, other broad action on NCDs was not featured in the conference resolutions.

The conference closed with the announcement that South Africa had won the bid for the 17th WCTOH, the first time the conference will be hosted by an African nation. The challenge was set with the words of Nelson Mandela: “I have walked that long road to freedom. I have tried not to falter; I have made missteps along the way. But I have discovered the secret that after climbing a great hill, one only finds that there are many more hills to climb”.

Related:

WHO report on regulation of e-cigarettes and similar products

27 Aug, 14 | by Becky Freeman, Web Editor

The following content is courtesy of the WHO.

The report on “Electronic nicotine delivery systems” (ENDS), of which electronic cigarettes are the most common prototype, is on the agenda of the 6th Conference of the Parties (COP) to the WHO Framework Convention on Tobacco Control (WHO FCTC), being held 13-18 October 2014, in Moscow.

E-cigarettes and similar devices are frequently marketed by manufacturers as aids to quit smoking, or as healthier alternatives to tobacco, and require global regulation in the interest of public health, this new World Health Organization (WHO) report states.

The report states that while e-cigarettes represent an “evolving frontier filled with promise and threat for tobacco control,” regulations are needed to:

  • Impede e-cigarette promotion to non-smokers and young people;
  • Minimize potential health risks to e-cigarette users and nonusers;
  • Prohibit unproven health claims about e-cigarettes; and
  • Protect existing tobacco control efforts from commercial and other vested interests of the tobacco industry.

It explains that while additional research is needed on multiple areas of e-cigarette use, regulations are required now to address health concerns, in particular for:

  • Advertising: An appropriate government body must restrict e-cigarette advertising, promotion and sponsorship, to ensure that it does not target youth and non-smokers or people who do not currently use nicotine.
  • Indoor use: legal steps should be taken to end use of e-cigarettes indoors in public and work places. Evidence suggests that exhaled e-cigarette aerosol increases the background air level of some toxicants, nicotine and particles.

Since 2005, the e-cigarette industry has grown from one manufacturer in China to an estimated US$3 billion global business with 466 brands, a market in which the tobacco industry is taking a greater stake. The report highlights WHO’s concern about the role of the tobacco industry in this market.

The regulations outlined in the report include a ban on e-cigarettes with fruit, candy-like and alcohol-drink flavours until it can be proved they are not attractive to children and adolescents. E-cigarettes have been marketed in almost 8 000 different flavours, and there is concern they will serve as a gateway to nicotine addiction and, ultimately, smoking, particularly for young people. Experimentation with e-cigarettes is increasing rapidly among adolescents, with e-cigarette use in this group doubling from 2008 to 2012, the report says.

Among other conclusions, the document found there was currently insufficient evidence to conclude that e-cigarettes help users quit smoking or not. Therefore, WHO currently recommends that smokers should first be encouraged to quit smoking and nicotine addiction by using a combination of already-approved treatments.

In addition, the report says existing evidence shows that e-cigarette aerosol is not merely “water vapour” as is often claimed in the marketing of these products. While they are likely to be less toxic than conventional cigarettes, e-cigarette use poses threats to adolescents and foetuses of pregnant mothers using these devices.

E-cigarettes also increase the exposure of non-smokers and bystanders to nicotine and a number of toxicants, the report says.

The COP is the central organ and governing body of the Convention and comprises 179 Parties as of today.

The WHO FCTC was adopted by the World Health Assembly on 21 May 2003 and entered into force on 27 February 2005. It has since become one of the most rapidly and widely embraced treaties in United Nations history.

Report on e-cigarettes to WHO Framework Convention on Tobacco Control

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