Health experts, especially those specialized in harm reduction, have declared as irrelevant the World Health Organization (WHO) Framework Convention on Tobacco Control (WHO FCTC), stating that in its current form, the instrument is not capable of influencing change in reducing harm among tobacco smokers.
The World Health Assembly adopted FCTC on 21 May 2003 and entered into force on 27 February 2005, being the first international treaty to be negotiated under the auspices of WHO. One of its major objectives was to reduce harm among smokers despite the fact that there were fewer nicotine options available at the time of its adoption.
During a virtual a virtual Ask Me Session on Tobacco Harm Reduction, Dr. Kgosi Letlape, questioned its relevance in this era.
Letlape proposed the creation of an appropriate framework for regulating nicotine products in accordance with the harm associated with those products.
“E-cigarettes and other nicotine products were introduced onto the market 10 years after the FCTC. When you look at the FCTC, you find that it was basically adopted in 2003. At the time that the FCTC was adopted, there was really only one main non-combustible product on the market which was Snus,” said Dr. Letlape.
He added that it is inappropriate to use it as a framework instead of looking at alternatives to combustible cigarettes.
“In the FCTC, there is Article 1 D, which speaks about Harm Reduction in relation to the challenges presented by Tobacco products. If you fast-track to now, you cannot apply the FCTC as it is to the risk-reduced products. What any well-meaning nation needs to do is to look at a framework for regulating the RRPs appropriately. Regulation of nicotine products must be based on evidence and science,” he narrated.
“One of the things that need to be taken out in terms of the FCTC is section 5.3, which refers to engagement of the industry. We know that there can be no solution without engaging the people that cause the problem. We need to engage the industry and encourage them to switch from producing combustible cigarettes, which are harmful to health, to producing alternatives which are less harmful. We need to create a legislative framework that will create access for people who smoke and will ensure that consumers are well-informed about the effect of these products.”
Dr Letlape further stated that there has been a switch in people and organizations moving from fighting tobacco smoking, to fighting nicotine in any form.
In his presentation, Dr Clive Bates, Director of Counterfactual, a consulting and advocacy practice focused on a pragmatic approach to sustainability and public health, urged countries to lobby and push for an FCTC that is in sync with their public health needs and Tobacco Harm Reduction aspirations.
“The FCTC is what the officials make it. Delegates to the COP10 happening on 20-25 November 2023 in Panama, should approach the FCTC with their national interest in mind, as well as Public Health priorities in mind and they should make sure the Convention does what they need it to do. If Malawi or any of the African countries disagrees with it, they can actually stop it. It is really important that delegates to the FCTC don’t just go with the flow. The facts are that this convention is very hostile to harm reduction. It is also very influenced by American Funded Non-Governmental Organisations (NGOs) who are very noisy and busy in the negotiations,” said Bates.
He added that American NGO’s influence in the FCTC is very prominent and delegates need to be aware of such machinations.
There are currently a number of novel nicotine products on the market and these don’t use any heat at all or they use electricity to heat an aerosol.
These include Vaping products, heated tobacco (heat not burn), unheated nicotine products, and more traditional smokeless tobacco and snus.