On World Cancer Day (Tues 4 February 2020), the World Health Organization (WHO) is focusing attention on the need to improve cancer care in low- and middle-income countries. On prevention of new cancer cases, the WHO cites “a wide range of proven interventions”, including controlling tobacco use. The statement released by the WHO to mark World Cancer Day identifies tobacco use as responsible for “25% of cancer deaths”. 1
1.1 billion people are estimated to smoke tobacco every day, of whom 80% are thought to live in low- and middle-income countries (LMIC). Many of these countries are not sufficiently resourced to implement and enforce tobacco control policies; numerous LMIC have large predicted populated increases, meaning the number of smokers is only likely to increase.
Despite this, the WHO refuses to recognise the potential of safer nicotine products, such as nicotine e-cigarettes, snus and heated tobacco products, in the fight against tobacco-related diseases such as cancer.
Providing access to safer nicotine products to support smokers who want to improve their health is called ‘tobacco harm reduction’. Harm reduction is not intended to replace existing tobacco control measures, but to complement them. Instead of ‘quit or die’, safer nicotine products offer smokers another choice: ‘quit and try’.
The Global State of Tobacco Harm Reduction (GSTHR) project maps the regulation and use of safer nicotine products and the public health potential of tobacco harm reduction. On 23 January 2020, the project published Tobacco harm reduction and the right to health, which places tobacco harm reduction in a broader harm reduction and human rights context.
1Embargoed WHO World Cancer Day press release: WHO outlines steps to save 7 million lives from cancer, embargoed until 00:01hrs CET on 04/02/20
“It is deeply regrettable that the World Health Organization’s stance on the use of safer nicotine products is impeding the fight against cancer, by ensuring that more people continue to smoke. It’s reminiscent of the WHO’s initial reluctance to accept harm reduction measures such as safe needle exchange in the fight against HIV/AIDS. The number of people directly affected by this mistaken approach, however, is in the millions.
“The WHO acknowledges that one in four cancer deaths is caused by tobacco smoking. Yet the organisation refuses to accept the wealth of independent and clinically peer-reviewed evidence to show that e-cigarettes, snus and heated tobacco products are not only much safer than combustible tobacco, but can help people to quit smoking at higher rates than other methods like nicotine replacement therapies. The active campaigning of the WHO on this matter has resulted in many countries banning the sale or use of these products."
“Denying people access to, and accurate information about, safer nicotine products denies them their right to health. This World Cancer Day, we are urging the WHO to reconsider its misguided position and to act quickly to protect millions of lives."
Today, Tuesday 10 December 2019, the World Health Organization (WHO) publishes the final report of the WHO Independent High Level Commission on Non Communicable Diseases.
In response, the publishers of the Global State of Tobacco Harm Reduction, which maps the regulation and use of safer nicotine products and the public health potential of tobacco harm reduction, have released the following statement.
"The WHO has previously recognised that tobacco is the one risk factor common to the four main groups of non-communicable diseases - cardiovascular disease, cancers, diabetes and respiratory diseases. The WHO also estimates that one billion people will die of tobacco-related diseases by the end of this century."
"In countries where they can access safer nicotine products like e-cigarettes/vapes, heated tobacco products and snus*, millions of people are empowering themselves, seizing their chance to live healthier lives by switching away from tobacco. Safer nicotine products are not risk-free but pose a fraction of the risk of tobacco cigarettes.
"Tragically, misinformation, poor policy making and knee jerk regulation is denying millions more consumers around the world the chance to make this change. We strongly urge the WHO to reconsider its misguided position on tobacco harm reduction, to demonstrate true leadership and take prompt action to protect millions of lives."