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Harm Reduction: an International Human Right

The latest Briefing Paper from the Global State of Tobacco Harm Reduction, titled: The Right to Health and the Right to Tobacco Harm Reduction, was launched during GFN22

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Tobacco harm reduction is not only a potentially life-saving public health intervention for the world’s 1.1 billion smokers, but also supported by international human rights law, according to the latest publication launched last week by Knowledge·Action·Change (K·A·C). 

Titled “The right to health and the right to tobacco harm reduction”, it is the sixth in a series of Briefing Papers produced by the UK-based public health agency as part of its Global State of Tobacco Harm Reduction project.

The paper recommends that tobacco harm reduction should be promoted as a health rights issue by the advocacy organisations that represent the people directly affected by its absence – those who use nicotine.

It argues that a human rights approach could offer significant opportunities to challenge the bad laws and policies across the world that currently prohibit, or restrict access to, the safer nicotine products that underpin tobacco harm reduction, such as vapes (e-cigarettes), Swedish-style snus, heated tobacco products and nicotine pouches.

Vapes, judged by Public Health England to be 95% safer than combustible cigarettes, are currently banned in 36 countries including Brazil, India and Mexico and snus cannot be sold in the EU despite the fact its popularity in Scandinavia has resulted in Europe’s lowest rates of both smoking and smoking-related diseases. 

From the early 2000s, human rights organisations campaigned to establish that harm reduction was a fundamental aspect of the right to health.

This approach was referenced by then UN Special Rapporteur on the Right to Health, Anand Grover, in his report to the UN General Assembly in August 2010 where he set out the principles for a health-based approach to drug control. It stated that “the enjoyment of the right to health of all people who use drugs – and are dependent on drugs – is applicable irrespective of the fact of their drug use”.

In contrast, the Briefing Paper says there was a lack of consideration of human rights issues in the drafting of the Framework Convention on Tobacco Control (FCTC), an international treaty negotiated through the World Health Organisation (WHO) that came into force in 2005 in response to the global nature of the public health crisis caused by tobacco use and smoking.

It says any subsequent advancement of human rights issues has focused mainly on the justification for demand and supply control strategies, prioritising the obligations of states to protect people from both tobacco products and the tobacco industry. This can be called a “freedom from” or “negative liberty” position.

On the other side there is the “freedom to” or “positive liberty” position. Regarding tobacco, this would include the freedom for people to choose safer alternatives to combustible cigarettes or risky oral tobacco products, to avoid smoking-related disease and premature death. Human rights discourse in tobacco control has neglected to address the issue of the right to health and an individual’s freedom to take positive steps to protect their own health.

This is despite a series of human rights conventions and other instruments adopted since the end of the Second World War, including the International Covenant on Economic, Social and Cultural Rights, have enshrined the right to health in international human rights law.

The neglect of the right to health being a basis of tobacco control means a huge resource for change – the opportunities for people to take charge of their health by switching to safer nicotine products – has been systematically undermined.

Speaking about the importance of the right to health, Professor Gerry Stimson, Director of K•A•C and Emeritus Professor at Imperial College London, said: “We desperately need an alternative narrative to the dominant tobacco control view that human rights can only be about protection from tobacco. This blind spot in tobacco control is costing millions of lives of every year. The right to control one’s health and body is at the core of tobacco harm reduction. It empowers people to make safer choices. Those of us involved in tobacco harm reduction need to build alliances with those working in human rights, explore challenges under international, regional, and national legislation, and establish tobacco harm reduction as fundamental to the right to health.”

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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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