Framework Convention on Tobacco Control 20th Anniversary

The role of tobacco harm reduction in assisting with the WHO’s FCTC

The 27th of February marks the 20th anniversary of the World Health Organisation’s (WHO) Framework Convention on Tobacco Control (FCTC). Describing itself as ‘an evidence-based treaty that reaffirms the right of all people to the highest standard of health,’ the FCTC ‘was developed in response to the globalization of the tobacco epidemic.’ It was also the WHO’s first-ever negotiated public health treaty.

As the leading cause of preventable death and disability around the world and described as a ‘plague on humanity’ by WHO Director-General Dr Tedros Adhanom Ghebreyesus, tobacco was and continues to be a very serious global health concern. Promisingly, the past two decades since the implementation of the WHO FCTC have seen a decline in global tobacco use by one-third.

At least part of this progress can be attributed to the convention, signed by 183 countries and covers 90% of the global population. Over the years, through the implementation of this treaty, up to 5.6 billion people are under one or more FCTC-aligned tobacco control policies. The MPOWER measurement package accompanying the FCTC has also been a strong asset for tobacco control.

However, there is still a long way to go – and moving away from the categorization of tobacco as an epidemic cannot happen through traditional tobacco control alone. It also requires the understanding, acceptance, and implementation of tobacco harm reduction (THR) policies, strategies, and products.

Not only can at least part of the global decline in tobacco use also be attributed to THR, but embracing THR is vital to meeting the global target of a 30% relative reduction in tobacco by the end of 2025. Yet, the WHO stands in its own way regarding harm reduction.

Despite popular misinformation, THR does not run contrary to tobacco control. The FCTC itself acknowledges the role of harm reduction in tobacco control within Article 1d:

“tobacco control” means a range of supply, demand and harm reduction strategies that aim to improve the health of a population by eliminating or reducing their consumption of tobacco products and exposure to tobacco smoke;

While acknowledging harm reduction strategies within this text, the WHO has unfortunately been either silent or openly discouraging THR policies and products. As recently as earlier this month, the WHO Director-General even made comments supporting the ban of e-cigarettes during the 156th Session of the WHO Executive Board, despite vaping’s wide recognition as an effective harm-reduction tool – and an effective one at that.

While acknowledging and celebrating the 20 years of the FCTC behind us, we hope that the WHO can embrace THR in order to make the 20 years ahead even more effective.