The FCTC COP10 Anti-THR Agenda and Its Implications

The anti-tobacco harm reduction (THR) agenda of the much dreaded COP10 being held next week in Panama, seems to confirm a shift from fighting the harms of tobacco to fighting solely nicotine.

The 10th session of the Conference of the Parties (COP10) to the Framework Convention on Tobacco Control (FCTC) is set to take place in Panama from February 5 to 10, 2024. This event, which has become renowned for its closed and secretive nature, was initially scheduled for November 2023, and sadly plays a crucial role in influencing global tobacco control policies. The focus of COP10 discussions will significantly impact the future of safer nicotine products (SNP), including nicotine vapes, snus, nicotine pouches, and heated tobacco products (HTP).

Despite harm reduction being one of the three pillars of the FCTC, the COP meetings have consistently ignored tobacco harm reduction. The COP10 documents, including the agenda and supporting papers, do not acknowledge SNPs as tools for public health improvement, despite the real-world data and science indicating their benefits. Instead, they present SNPs as a threat to tobacco control and advocate for regulations that treat all nicotine and tobacco-containing products uniformly, without distinguishing between high-risk tobacco products and safer alternatives.

The main threats to tobacco harm reduction
A recent GSTHR briefing report listed the key threats to tobacco harm reduction and consumer access to SNPs outlined in the COP10 documents:

1.Treating all SNPs the same as combustible tobacco.
2.Extending and applying regulations for tobacco products to all forms of nicotine and tobacco products.
3.Defining all aerosols emitted from “novel and emerging tobacco products” as ‘smoke.’
4.Applying prohibition and/or regulation to SNPs similar to conventional cigarettes, including large graphic health warnings, plain packaging, and bans on advertising, promotion, and sponsorship.
5.Imposing a ban on all ‘open system’ vaping products.
6.Banning all flavours except tobacco for all SNPs.
7.Taxing all nicotine-containing products at the same rate as cigarettes.

The COP10 documents lack evidence to support these policy recommendations, and the evidence included is selective, not citing the latest findings from the Cochrane Review, a global gold standard of systematic reviews.

Several agenda items are of particular relevance to SNPs and tobacco harm reduction:

1.Implementation of Articles 9 and 10 of the WHO FCTC (Regulation of contents and disclosure of tobacco products).
2.Tobacco advertising, promotion, and sponsorship: depiction of tobacco in entertainment media.
3.Novel and emerging tobacco products: reports by the Convention Secretariat and by WHO.

Trying to redefine vapour as smoke
The COP10 agenda seeks to apply existing regulations to SNPs, categorizing them similarly to combustible tobacco. The potential outcomes include bans on SNP, restrictions on marketing, graphic health warnings, plain packaging, and advertising bans. The documents lack a clear definition of “novel and emerging tobacco products” and attempt to redefine aerosols emitted by SNP as ‘smoke.‘

As in previous years, consumer advocacy groups face limited avenues to influence COP decisions, and reform of the FCTC relies on the actions of member states. The Taxpayers Protection Alliance’s (TPA) Consumer Center has criticized the WHO FCTC for ignoring science and consumer rights in its pursuit of restrictive tobacco control measures. Martin Cullip, an international fellow at TPA, accused the WHO FCTC of focusing on policies known as MPOWER, which restrict the supply and demand of tobacco products, while neglecting other proven measures to help smokers quit.

Cullip highlighted that the WHO’s approach has not effectively reduced global smoking rates and questioned its shift from tackling the harms of tobacco smoke to fighting nicotine itself. He criticized the alleged disregard for harm reduction strategies and accused the WHO of promoting prohibition instead of embracing evidence-based approaches. Cullip called for greater public participation in WHO FCTC policy discussions and urged countries to explore alternative methods beyond those dictated by the WHO to address smoking challenges effectively.