Discussions on Tobacco Control and the Absence of Discussions on THR
The 156th session of the WHO Executive Board took place from February 3rd to 11th, 2025, with a heavy emphasis on addressing noncommunicable diseases, equitable access to healthcare, and immunization. The direction of these conversations was established from the very start through WHO Director-General Tedros Adhanom Ghebreyesus’ opening remarks to the audience.
Promisingly, Dr. Tedros almost immediately mentions tobacco as a risk factor for noncommunicable diseases and emphasizes its status as the world’s leading cause of preventable death. He shares how, over the past twenty years, the worldwide smoking prevalence has reduced by a third. However, in a Director-General report presented at the session, Dr. Tedros also shares that “the global target of a 30% relative reduction by 2025 is unlikely to be met except in the case of women and some regions (Africa and South-East Asia).”
Amidst the celebrations and re-evaluations, the mention of tobacco harm reduction (THR) was notably missing during this session. This absence is particularly highlighted as THR is sure to be credited for at least a portion of the smoking prevalence reduction, while the lack of THR can help account for the WHO’s failure to meet its global target. This can clearly be seen in the fact that countries that have embraced THR and its evidence-based policies, such as Sweden and New Zealand, are well on their way to achieving their goals of being smoke-free by 2030.
The WHO does not stop at failing to mention THR as an evidence-based and risk-proportionate policy method that works alongside tobacco control, but it also goes on to condemn THR products. In Dr. Tedros’ opening speech, he specifically recognizes Vietnam for prohibiting e-cigarettes and heated tobacco products, adding that this was done “with WHO support”. This clearly shows the WHO’s active opposition to THR, despite the fact that vaping and nicotine pouches are proven to be 99.75% less risky than cigarettes, and vapes are 5 times more likely to help a smoker quit than those who go cold turkey.
It is past time that the WHO realises how THR products, when implemented in the risk-proportionate way that THR promotes, are part of a well-rounded tobacco control policy – not outside of it and certainly not opposed to it. While we wait for this change, we will continue to challenge misconceptions, fight myths, and share the benefits of THR.
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