More than 40 international health experts have issued a joint statement urging the World Health Organization (WHO) to update its approach to tobacco control and give greater consideration to harm reduction strategies.
The statement, released via The Counterfactual’s “Expert Wall,” calls on the WHO and the Secretariat of the Framework Convention on Tobacco Control (FCTC) to put harm reduction at the center of discussions during the recent the 11th Conference of the Parties (COP11) in Geneva.
The experts argue that the WHO’s long-standing focus on abstinence overlooks available scientific evidence and the potential of newer nicotine technologies to reduce smoking-related disease. They warn that the current stance misinforms the public and slows progress toward ending cigarette use.
“The goal of reducing the toll of death and disease caused by tobacco requires policies that accurately reflect the epidemiological evidence on the harms of different types of tobacco and nicotine products,” said Dr. Robert West of University College London.
Imperial College London’s Dr. David Nutt highlighted the global impact of smoking. “Smoking causes a massive burden of death and disease worldwide, killing about 8 million people annually,” he said. “We now have vaping and other smoke-free alternatives to cigarettes that can dramatically cut the risks for people who cannot or do not want to quit using nicotine.”
Former WHO official Dr. Ruth Bonita pointed to international experience supporting harm reduction. “Independent evidence, including real-world evidence from New Zealand, shows that regulated, reduced-harm smoke-free nicotine products can accelerate declines in smoking and prevent disease,” she said.
Dr. Ann McNeill urged the WHO to broaden its scientific engagement, saying the agency must “engage openly with all credible scientists, not just those who echo an ideological line.”
Several experts also raised concerns about the agency’s messaging. Dr. Andrzej Fal said the WHO’s “purist line” on nicotine risks diverting attention from reducing disease. “As a pragmatist and practitioner, I believe we should prioritize reducing disease and death, and that means we should focus on reducing smoking in any way we can,” he said.
Dr. Neal Benowitz said non-combusted products should be part of cessation strategies and that the FCTC’s goal “should be to promote the elimination of cigarettes and other smoking products” rather than broadly restricting nicotine.
Dr. Kenneth Warner said the evidence on vaping is clear and warned that ignoring it could lead to preventable deaths. He added that concerns about youth vaping have been “grossly exaggerated.”
Dr. K. Michael Cummings cited Sweden, New Zealand, the United States and England as examples of countries that have reduced smoking rates through access to lower-risk alternatives, calling the WHO’s position a continuing “blind spot.”