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Expert Response to the 100’s Letter

Experts have responded to last week’s letter sent to the 182 countries signed up to the Framework Convention on Tobacco Control by 100 leading specialists

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Last week, 100 nicotine science, policy and practice specialists wrote a letter to the 182 countries signed up to the Framework Convention on Tobacco Control. It urged them to take a more positive stance on tobacco harm reduction. A number of harm reduction experts have made comment.

The letter (1) recommended:

  • Make tobacco harm reduction a component of the global strategy
  • Insist that any policy analysis makes a proper assessment of benefits to smokers or would-be smokers
  • Require any policy proposals to reflect the risks of unintended consequences
  • Properly address genuine tobacco industry malpractice, not create a barrier to reduced-risk products
  • Make negotiations more open to stakeholders with harm-reduction perspectives
  • Initiate an independent review of WHO and the FCTC approach to tobacco policy

Professor David Nutt, Imperial College, said: “Smoking causes a massive burden of death and disease worldwide, killing about eight million people annually and so on a similar scale to the COVID pandemic so far. But we now have vaping and other smoke-free alternatives to cigarettes that can dramatically cut the risks for people who cannot or do not want to quit using nicotine. There is no real scientific doubt that these smoke-free products are much safer than smoking and that they can help smokers quit. So, we should be working hard to make that happen.

“And yet the World Health Organisation has dug in against vaping and the other alternatives and is throwing every possible obstacle in the way. WHO continues to insist that smokers should just stop, even though we know millions of smokers simply will not do that and millions will continue to take up the habit. There are no other areas of public health where just demanding abstinence or trying to enforce abstinence via prohibition is seen as a credible strategy, but that is exactly what WHO is advocating for nicotine. The idea of harm reduction is deeply embedded in drugs and sexual health policy, for example. But for nicotine, it seems WHO would rather adopt an ideological stance and fail than take a pragmatic approach and save lives.”

Dr Ruth Bonita, a former Director of WHO’s Department of Non-Communicable Disease Surveillance, and Dr Robert Beaglehole, a former Director WHO’s Department of Chronic Disease Prevention and Health Promotion damningly stated: “Effective public health efforts need to be based on science, reason and humanism. Yet the world’s premier health body is aligning itself against all three when dealing with nicotine. The result is that one of the greatest opportunities to improve global health, separating nicotine use from smoke inhalation, is being squandered.

“Global trust in health authorities, and the WHO in particular, has never been so important. Yet the WHO is abandoning science, rationality and humanism on nicotine and instead apparently pursuing the moralistic abstinence-only agenda of external funders. This is a public health tragedy that extends well beyond the unnecessary sickening of the billion-plus people who smoke cigarettes.”

Dr Raymond Niaura, a Professor of Social and Behavioural Sciences at New York University School of Global Public Health, added: “Vaping and snus are likely to be the greatest health advance of this coming century and could save nearly a billion lives. The WHO should embrace the opportunity not block it.”

Dr David Nutt, Professor of Neuropsychopharmacology at Imperial College London, joined in the attack: “The WHO blithely, and quite wrongly, claims that switching from smoking cigarettes, by far the leading preventable cause of premature death and disability, to far less harmful e-cigarettes—which they cleverly but unscientifically imply may be deadly—is not quitting.”


  1. 100 Expert Voices -

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Dave Cross avatar

Dave Cross

Journalist at POTV
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Dave is a freelance writer; with articles on music, motorbikes, football, pop-science, vaping and tobacco harm reduction in Sounds, Melody Maker, UBG, AWoL, Bike, When Saturday Comes, Vape News Magazine, and syndicated across the Johnston Press group. He was published in an anthology of “Greatest Football Writing”, but still believes this was a mistake. Dave contributes sketches to comedy shows and used to co-host a radio sketch show. He’s worked with numerous vape companies to develop content for their websites.

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