As global tobacco control architecture evolves, there’s growing concern that the WHO is reading its own treaty, the Framework Convention on Tobacco Control (FCTC), too narrowly. Ironically, while the FCTC explicitly includes harm reduction strategies in its mandate, WHO has sometimes dismissed reduced-risk nicotine products as part of industry rhetoric to be disregarded. This contradiction is not just ironic; it undermines effective policy and public health outcomes.
Harm Reduction Is in the Treaty, Yet Overlooked
Article 1(d) of the FCTC defines tobacco control as including harm reduction strategies, signaling that safer alternatives should have their place in global tobacco policy. Yet platforms like WHO often dismiss e‑cigarettes, nicotine pouches, and oral nicotine as “industry narratives”, ignoring the treaty’s language. This misalignment between text and practice represents a missed public health opportunity.
FCTC Articles Support Reasoned Regulation of Novel Products
Key articles under the treaty, such as Article 9 (contents), Article 10 (disclosure), Article 13 (advertising), and Article 16 (sales to minors), provide clear legal infrastructure to regulate flavors, packaging, marketing, and youth access of novel nicotine products.
COP decisions since 2016 have included heated tobacco products under the treaty’s remit, indicating that the FCTC framework can, and should, be applied to emerging technologies.
Why Misinterpretation Matters
A narrow, prohibitionist approach puts countries without harm reduction strategies at a disadvantage. As seen in Sweden and the UK, integrating products like snus and e‑cigarettes into tobacco control plans has accelerated the decline in smoking rates. Ignoring harm reduction risks perpetuates combustible tobacco use rather than curbing it.
Meanwhile, reporting errors and omnibus misinterpretations, such as those found in nearly one-third of country reports to WHO, undermine the treaty’s effectiveness and prevent evidence-based policy-making.
What a Constructive FCTC Can Look Like
Rather than outright rejection, the treaty provides a foundation for reasonable regulation:
- Regulate flavors and ingredients for youth protection
- Enforce age restrictions, online verification, and smoke-free zones
- Require ingredient disclosures and health warnings
- Ban marketing that targets youth
- Monitor and control industry interference via Article 5.3 measures
These are precisely the kinds of frameworks being advanced in national discussions, from the EU to France and beyond.
GINN’s Take: Harmonizing Treaty Language and Policy
If WHO truly aims to reduce tobacco-related deaths globally, it must realign its messaging with its central treaty. This means engaging supportively, not dismissively, with reduced-risk product science. It also means inviting harm reduction experts and consumer advocates into policy dialogues to ensure clarity and nuance.
Countries should be encouraged, not deterred, from crafting balanced tobacco control policies that distinguish between combustion and smoke-free nicotine options, using the FCTC as a guide, not a muzzle.
FCTC Is Stronger with Harm Reduction
Smoke-free nicotine alternatives are not a threat to tobacco control; they’re part of it. Failing to implement the treaty as intended risks stagnating smoking rates and ignoring real-world progress in countries that embrace harm reduction. By reaffirming its own treaty’s provisions on harm reduction and resisting ideological shortcuts, WHO can strengthen global tobacco control, one smoke-free user at a time.
