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The World Health Organisation (WHO) have a record of opposing electronic cigarettes, in a meeting to be held on the 13th– 18th August discussing the WHO international treaty Framework Convention on Tobacco Control (FCTC) it is widely expected that they will call for the classifying of ecigs as tobacco products. Such a move would oblige the 178 countries who have signed up to the treaty to implement measures similar to those on tobacco cigarettes, that includes – raising taxes, banning advertising, introducing health warnings and curbing use in public places.

FCTC Threat

Included in the 178 countries who are signatories to the FCTC is the UK, in fact 90% of the world population are potentially affected by the FCTC, the USA and Switzerland the notable exceptions.

The reason that it is widely anticipated that the WHO FCTC will be anti ecig is because of their past record and most especially leaked FCTC Bureau minutes indicating that they wanted to class e-cigs as tobacco products.

If FCTC classify ecigs as tobacco products then they would be doing more to regulate, restrict and control ecigs than the proposals of regulators in Europe and the United States. As stated above, the UK has signed up to the FCTC and will be obliged to implement its terms.

Expert Response

Luckily 53 leading experts have signed an open letter to the WHO warning them of the dangers of classifying ecigs as a tobacco product.

Their letter is brilliant, it is a clear and straightforward statement of fact and rational opinion regarding ecigs and their potential roll in reducing the horrifying number of preventable early deaths that are brought about by tobacco use.

The letter is reproduced on Clive Bates’s website ‘The Counterfactual’ and is also available in PDFformat. I very strongly recommend that you read the letter, it is brilliant.

You should also read through the list of signatories at the bottom of the letter, it would be hard to imagine a better ‘best of’ list of creditable and knowledgeable experts in the field. From the UK are Professor Linda Bauld (Professor of Health Policy. Director of the Institute for Social Marketing. Deputy Director, UK Centre for Tobacco and Alcohol Studies. University of Stirling), Professor John Britton (Professor of Epidemiology. Director, UK Centre for Tobacco & Alcohol Studies. Faculty of Medicine & Health Sciences University of Nottingham), Dr Lynne Dawkins (Senior Lecturer in Psychology. Co-ordinator: Drugs and Addictive Behaviours Research Group. School of Psychology, University of East London), Professor Peter Hajek (Professor of Clinical Psychology and Director, Health and Lifestyle Research Unit. UK Centre for Tobacco and Alcohol Studies. Wolfson Institute of Preventive Medicine. Barts and The London School of Medicine and Dentistry Queen Mary University of London), Professor Martin Jarvis (Emeritus Professor of Health Psychology. Department of Epidemiology & Public Health. University College London), Dr Jacques Le Houezec (Consultant in Public Health, Tobacco dependence, Rennes, France. Honorary Lecturer, UK Centre for Tobacco Control Studies, University of Nottingham), Professor Ann McNeill (Professor of Tobacco Addiction. Deputy Director, UK Centre for Tobacco and Alcohol Studies. National Addiction Centre. Institute of Psychiatry. King’s College London), Dr Hayden McRobbie (Reader in Public Health Interventions. Wolfson Institute of Preventive Medicine. Queen Mary University of London), Professor Marcus Munafò (Professor of Biological Psychology. MRC Integrative Epidemiology Unit at the University of Bristol. UK Centre for Tobacco and Alcohol Studies. School of Experimental Psychology University of Bristol), Professor David Nutt (Chair of the Independent Scientific Committee on Drugs (UK). Edmund J Safra Professor of Neuropsychopharmacology. Head of the Department of Neuropsychopharmacology and Molecular Imaging Imperial College London), Dr Martin Raw (Special Lecturer. UK Centre for Tobacco and Alcohol Studies. Division of Epidemiology and Public Health. University of Nottingham), Professor Gerry Stimson (Emeritus Professor, Imperial College London. Visiting Professor, London School of Hygiene and Tropical Medicine), Professor David Sweanor (Adjunct Professor, Faculty of Law, University of Ottawa. Special Lecturer, Division of Epidemiology and Public Health, University of Nottingham) and Professor Robert West (Professor of Health Psychology and Director of Tobacco Studies. Health Behaviour Research Centre, Department of Epidemiology & Public Health, University College London)… that extensive list is only those signatories associated with the UK, many other equally creditableexperts from other countries also signed the letter.

The Letter

Clive Bates had a hand in organising this letter and he gives an excellently detailed ‘Readers Guide’ on his website, I recommend that you read it.

Much of the letter is full of quotable snippets such as the following wise words;

  • 1.3 billion people who currently smoke could do much less harm to their health if they consumed nicotine in low-risk, non-combustible form.
  • We have known for years that people ‘smoke for the nicotine, but die from the smoke’: the vast majority of the death and disease attributable to tobacco arises from inhalation of tar particles and toxic gases drawn into the lungs. There are now rapid developments in nicotine-based products that can effectively substitute for cigarettes but with very low risks. These include for example, e-cigarettes and other vapour products
  • Even though most of us would prefer people to quit smoking and using nicotine altogether, experience suggests that many smokers cannot or choose not to give up nicotine and will continue to smoke if there is no safer alternative available that is acceptable to them.
  • Tobacco harm reduction is part of the solution, not part of the problem. It could make a significant contribution to reducing the global burden of non-communicable diseases caused by smoking, and do so much faster than conventional strategies.
  • Tobacco harm reduction policies should be evidence-based and proportionate to risk, and give due weight to the significant reductions in risk that are achieved when a smoker switches to a low risk nicotine product.
  • On a precautionary basis, regulators should avoid support for measures that could have the perverse effect of prolonging cigarette consumption. Policies that are excessively restrictive or burdensome on lower risk products can have the unintended consequence of protecting cigarettes from competition from less hazardous alternatives, and cause harm as a result.
  • … reduction of tobacco consumption should be aligned with the ultimate goal of reducing disease and premature death, not nicotine use per se, and therefore focus primarily on reducing smoking.
  • It is counterproductive to ban the advertising of e-cigarettes and other low risk alternatives to smoking. The case for banning tobacco advertising rests on the great harm that smoking causes, but no such argument applies to e-cigarettes
  • It is inappropriate to apply legislation designed to protect bystanders or workers from tobacco smoke to vapour products. There is no evidence at present of material risk to health from vapour emitted from e-cigarettes.
  • The tax regime for nicotine products should reflect risk and be organised to create incentives for users to switch from smoking to low risk harm reduction products. Excessive taxation of low risk products relative to combustible tobacco deters smokers from switching
  • WHO and national governments should take a dispassionate view of scientific arguments, and not accept or promote flawed media or activist misinterpretations of data.
  • The potential for tobacco harm reduction products to reduce the burden of smoking related disease is very large, and these products could be among the most significant health innovations of the 21st Century – perhaps saving hundreds of millions of lives.

Gratifyingly, this letter was well reported on in the media, for example ‘Top scientists warn WHO not to stub out e-cigarettes (Reuters) and ‘Resist urge to control e-cigarettes’, WHO told’ (BBC).

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