”Harm-reduction” maintains the global tobacco epidemic

10 November 2021

Helen Stjerna.  Source: The Brussels Times

“Tobacco Harm-Reduction Experts” are pushing WHO to loosen its stance on new tobacco products, such as e-cigarettes, heated tobacco products and nicotine pouches.

These products are falsely marketed as safer and more sustainable options to deadly cigarettes, misleading consumers, media and international institutions. Prior to COP9 to the WHO FCTC, over 40 organizations and professors from all continents urge delegates and policymakers to acknowledge nicotine addiction – in all forms – as a threat to global sustainable development, and to protect the future of the world´s young generation.

Lifeline of the tobacco industry

Smoking prevalence is declining in many high-income countries as a result of measures for tobacco control and health awareness. The cigarette business is threatened and the tobacco industry´s response is to develop new tobacco and nicotine products, which can appeal to new customers.

Reports from all over the world reveal the increasing use of e-cigarettes and nicotine pouches among young people. In some contexts this alarming trend has been described as an epidemic. Due to rapid increase in popularity, many multinational tobacco companies have launched their own brands and are expanding their markets all over the world.

These new products are portrayed as modern, innovative and “fresher” versions of traditional cigarettes and oral tobacco. Also, they are broadly marketed as “tobacco-free” – even though they contain high amounts of nicotine that is extracted from tobacco.

There is an urgent need to reveal the lies of the tobacco industry before the global community is facing an epidemic of nicotine addiction on an even larger scale.


The marketing of new nicotine products as ”tobacco-free” is a strategy designed to circumvent national legislations regulating tobacco products. The companies exploit legal loopholes where these products are currently exempted from rules on marketing, taxation, age limits, sales permits etc.

Another purpose of this strategy is to make them appear less harmful. The new products are portrayed as better alternatives to cigarettes, and effective tools for smoking cessation, in hope to improve the image of the tobacco industry and to convince consumers, investors and policymakers about their societal contribution.

This is simply a cover to hide and at the same time promote their true agenda – to lure youth into a lifetime of nicotine addiction. The tobacco industry knows that almost all tobacco users start in their teens or even earlier. Independent studies show that new nicotine products do not help current smokers quit, but instead risk becoming a gateway to nicotine addiction and smoking among youth.

E-cigarettes and nicotine pouches, that come in thousands of flavours and are marketed through influencers in social media, are undoubtedly made to appeal to young people. A looser regulatory stance towards these products would enable the industry to continue targeting every young generation, and ultimately cause more harm.

Nicotine is anything but harmless

When promoting smoke-free tobacco products (oral tobacco, e-cigarettes and heated tobacco) the industry constantly repeats the same argument; “smoking and the burning of tobacco is the problem, not the nicotine.” By highlighting health benefits of smoke-free tobacco products – in comparison with a product that kill eight million people every year – the industry aims to position these products as part of the solution to the global tobacco epidemic.

This strategy also works to disguise the severe health effects of nicotine, which tend to be undermined and disregarded despite the substantial number of studies proving that nicotine is far more than addictive. Nicotine permanently damages the brain, impairs cognitive functions and increases risk of mental illness; type 2-diabetes, cardiovascular disease, lung disease, birth defects and other drug abuses.

Young people are especially vulnerable to cognitive damage and risk long-term complications. There is compelling scientific evidence emphasizing the need to prevent nicotine addiction, no matter which product, for the sake of public health.

Human rights violations and environmental impact

The on-going debate on relative risks and “harm-reduction” is not only stalling necessary efforts to enhance global health, but also threatens a fair and sustainable development. Tobacco counteracts all 17 of the Sustainable Development Goals, and is not only the primary preventable cause of death and disease, but also leads to deforestation, loss of biodiversity, pollution, waste, poverty, inequality and widespread child labour.

According to the ILO, at least 1.3 million children under 14 years of age are involved in hazardous child labour on tobacco farms around the world – risking both health and education. Child labour in tobacco farming is classified as one of the worst forms of child labour. Every international institution and policy makers on all levels need to be informed about the wide array of negative effects of the entire production chain.

This knowledge undermines all (tobacco industry) arguments motivating “special treatment” of some products in legislation or investment portfolios.

Global agreements

Since WHO adopted the Framework Convention on Tobacco Control (FCTC) almost 20 years ago, all parties have had access to the knowledge needed to reduce and prevent tobacco use. The Convention clearly encourages all parties to implement measures to phase out all tobacco products (defined as products entirely or partly made of the leaf tobacco) and exclude the influence of the tobacco industry from decision-making regarding public health policy. The global tobacco epidemic is one of many obstacles to overcome in order to achieve the SDG:s by 2030, but if the FCTC is implemented worldwide to protect youth from nicotine addiction the chances will be significantly better.

The purpose of the COP9 is to promote a healthier and more sustainable world through comprehensive tobacco control. There is no time or room for a more tolerant stance towards any types of tobacco and nicotine products. Over 40 organisations and professors – working to protect children and youth from nicotine addiction around the world – urge delegates and policymakers to commit to the following actions:

–      Strict implementation of the WHO FCTC worldwide
–      Strict regulation of all tobacco and tobacco-related products in national legislations
–      Exclusion of tobacco industry interference from public health policy
–      Exclusion of tobacco and tobacco-related companies from investment portfolios 

  • Helen Stjerna, Secretary-General, A Non Smoking Generation, Sweden
  • Kristina Sparreljung, Secretary-General, Swedish Heart Lung Foundation, Sweden
  • Linnea Hedman, Associate professor of epidemiology and public health, Umeå University, Sweden
  • Farida Akhter, Executive Director, UBINIG (Policy Research for Development Alternative), Bangladesh
  • Sayyida Akhter, Coordinator, Alliance of Women against Tobacco, TABINAJ, Bangladesh
  • Sonja von Eichborn, Director Unfairtobacco, Germany
  • Dr Koong Heng Nung, Founder & Director, Tobacco Free Generation International Limited, Singapore
  • Lisa Lu, CEO, International Youth Tobacco Control, USA
  • Marty Otañez, PhD, Chair and Associate Professor, Anthropology Department, University of Colorado Denver, USA
  • Raul Barbosa, Vice-President, External Affairs of the International Federation of Medical Students’ Associations of Brazil
  • Mervi Hara, Executive Director, ASH Finland
  • David Odhiambo, Director, Den of Hope Youth Group, Kenya
  • Maurice Swanson, Chief Executive, Australian Council on Smoking and Health, Australia
  • Kurt Aigner, MD, FCCPem., President, Austrian Council on Smoking and Health, Austria
  • Cornel Radu Loghin, Secretary-General, European Network for Smoking and Tobacco Prevention, Belgium
  • Francisco Rodriguez Lozano, President, European Network for Smoking and Tobacco Prevention, Spain
  • Krzysztof Przewozniak, Foundation “Smart Health”, Poland
  • Florin Mihaltan, Romanian Society of Pneumology, Romania
  • Loic Josseran, French Alliance Against Tobacco (ACT), France
  • Luciano Ruggia, Director, Swiss Association for Tobacco Control, Switzerland
  • Lucienne Thommes, Director, Fondation Cancer Luxembourg
  • Nijole Gostautaite Midttun, President, Lithuanian Tobacco and Alcohol Control Coalition, Lithuania
  • Ramona Brad, President, Healthy Romania Generation 2035 Association, Romania
  • Gergana Geshanova, Chair of the Board, Smoke Free Life Coalition, Bulgaria
  • Andrés Zamorano, President, Comité Nacional para la Prevención del Tabaquismo – CNPT, Spain
  • Francisco Cabrera Panasco, President, Fundacion Canaria Dental, Spain
  • George Bakhturidze, Founder, FCTC Implementation and Monitoring Center in Georgia
  • Marius Eremia, Executive Director, Association Aer Pur Romania, Romania
  • Marija Zdraveska, Macedonian Respiratory Society, Macedonia
  • Raquel Fernández Megina, President, Nofumadores, Spain
  • Uliana Bakh, Executive Director, PROI, Bosnia and Herzegovina
  • Jan Peloza, International Youth Health Organization and No Excuse Slovenia
  • Coral Malfaz, Official College of dentists of Santa Cruz de Tenerife, Spain
  • Mihaela Lovse, Slovenian Coalition for Public Health, Environment and Tobacco Control, Slovenia
  • Luke Clancy, TobaccoFree Research Institute Ireland
  • Lena Sjöberg, President, Tobaksfakta, Sweden
  • Margianta Surahman Juhanda Dinata, Executive Director, Emancipate Indonesia, Spokesperson, FCTC untuk Indonesia, Ambassador, One Young World, Indonesia
  • Sanele Zulu, Convener of the South African Tobacco Free Youth Forum, South Africa
  • Dra. María Paz Corvalán, Director, Alianza ENT Chile
  • Shkumbin Spahija, KADC – Kosovo Advocacy and Development Center, Kosovo
  • Silvano Gallus, Instituto di Ricerche Farmacologiche Mario Negri, Italy
  • Jamilya Sadykova, Public fund ”Temekisiz”, National coalition ”For smokefree Kazakhstan”, Kazakhstan
  • Enkeleint A. Mechili, University of Vlora “Ismail Qemali”, Department of Healthcare, Albania
  • Dr. Marie Hauerslev, Chair, NCD Child, Denmark
  • Friedrich J. Wiebel, Prof. Dr. med, Chairman, German Medical Action Group Smoking or Health (GMASH), Germany
  • Esteve Fernández, MD, MPH, PhD, Professor of Preventive Medicine and Public Health, School of Medicine, Universitat de Barcelona, Director, Cancer Epidemiology and Prevention Department & WHO Collaborating Center for Tobacco Control, Institut Català d’Oncologia (ICO) / Institut d’Investigació Biomèdica de Bellvitge (IDIBELL), Spain