E-Cigarettes: Tobacco industry misinformation on e-cigarettes, a ‘real threat’, says WHO

1 August 2019 – The World Health Organization (WHO) stated that e-cigarettes are “undoubtedly harmful”, and warned that misinformation spread by the tobacco industry in claiming that they are “safer” constitute “a present and real threat” to public health.

The tobacco industry has been aggressively marketing e-cigarettes as a less dangerous alternative to traditional cigarettes and as smoking cessation aids. However, the WHO stated that “the available evidence does not support the tobacco industry’s claim that these products are less harmful” compared to traditional tobacco products. E-cigarettes are “not harmless and must be regulated”, the health organization affirmed. The WHO also warned against the use of e-cigarettes by smokers trying to quit, as there is insufficient evidence on their effectiveness as smoking cessation aids. The WHO reported that, in most cases, e-cigarettes are used concurrently with traditional cigarettes, “with little to no beneficial impact on health risk and effects.” 

Studies so far have shown that the use of e-cigarettes: harms the heart, lungs, blood vessels, the immune system, and airways;[i] can lead to breathing problems, pneumonia and wet lung;[ii] and affects the brain development of babies.[iii]  E-cigarettes have been found to contain carcinogens, formaldehyde and other poisons,[iv] and have flavors and sweeteners that cause cancer.[v] Several countries now ban e-cigarettes or nicotine content.[vi] At least 42 countries ban the sale or distribution of e-cigarettes, while at least 56 countries allow their sale but provide sales restrictions or regulations, such as cross-border restrictions, venues where they can be sold, access restrictions, among others.[vii] Of the countries that allow the sale of e-cigarettes, at least 30 regulate the amount (concentration/volume) of nicotine in e-liquids.[viii]

The tobacco epidemic is one of the biggest public health threats in the world. It kills more than 8 million people each year. Today, there are about 1.1 billion smokers worldwide, most of them live in low- and middle-income countries.[ix] Nonetheless, the tobacco industry continues to strategize on ways to maintain demand for its products in the market, including by introducing new products like e-cigarettes, heated tobacco products (HTPs), electronic nicotine delivery systems (ENDS) and electronic non-nicotine delivery systems (ENNDS).[x]

The move is part of the tobacco industry’s strategy to redefine itself as “transformed” by providing public health solutions in offering the new products. Philip Morris International (PMI) went further by funding Foundation for a Smoke-Free World (FSFW), a non-profit organization established to provide grants for “medical, agricultural, and scientific research to end smoking and its health effects and to address the impact of reduced worldwide demand for tobacco”.[xi]

A leaked 2014 PMI[xii] corporate affairs document shows that the establishment of FSFW is consistent with, and in fact operationalizes, the company’s corporate strategy to further its business interest for its “reduced-risk products” (RRP), as well as traditional (i.e. “combustible”) tobacco products. Its support for FSFW allows PMI to portray itself as a credible stakeholder in the public health debate by elevating “the concept of harm reduction as legitimate public policy in tobacco regulation.”[xiii]  However, contrary to their declared support for “harm reduction”, the same leaked corporate affairs document outlines how PMI seeks to “maximize commercial opportunities and grow market share” for its traditional tobacco products.[xiv] Their marketing strategy both for e-cigarettes and traditional cigarettes have moreover been found to target children,[xv] undermining gains in public health policy. [xvi]

The WHO has issued a statement declaring that it will not partner with FSFW and advising governments to do the same, in line with Article 5.3 of the WHO FCTC, considering the clear conflict of interest involved in a tobacco company funding a purported health foundation while it continues to promote sales of its tobacco and other products.[xvii] This echoes the WHO FCTC Secretariat’s statement, noting how collaboration with FSFW, a tobacco industry funded entity, would constitute a breach of Article 5.3 of the WHO FCTC, and forms part of the tobacco industry’s marketing and public relations strategy falling within the scope of tobacco advertising, promotion and sponsorship.[xviii] Numerous public health organizations and individual advocates have denounced an attempt by FSFW to partner with the WHO in breach of these principles.

Article 5.3 of the WHO FCTC provides that parties must protect public health policies from commercial and other vested interests of the tobacco industry. The adopted guidelines for implementation of Article 5.3 expressly state that there is a “fundamental and irreconcilable conflict between the tobacco industry’s interest and public health policy interests”, and thus recommend that governments reject partnerships and non-binding or non-enforceable agreements with the tobacco industry. The WHO has identified that tobacco industry interference, combined with the emergence of new tobacco products, are considered to be the most serious barriers to progress in public health.[xix]

 

Global Center for Good Governance in Tobacco Control (GGTC) aims to address the single greatest obstacle to tobacco control, tobacco industry interference. It is a joint initiative of the School of Global Studies, Thammasat University and Southeast Asia Tobacco Control Alliance (SEATCA) and has been designated as the WHO Framework Convention on Tobacco Control Secretariat as the Knowledge Hub on Article 5.3, (treaty provision on countering tobacco industry interference).  GGTC is also a key partner of the Bloomberg Philanthropies’ Stopping Tobacco Organizations and Products (STOP).

 

 

FOR MORE INFORMATION:

Global Center for Good Governance in Tobacco Control. E-CIGS: The future of addiction. 16 July 2018. Retrieved from https://ggtc.world/2018/07/16/e-cigs-the-future-of-addiction/ 

Global Center for Good Governance in Tobacco Control. E-CIGS: Myth. Retrieved from https://ggtc.world/2018/07/16/e-cigs-myths/

Global Center for Good Governance in Tobacco Control. E-cigarette ban & regulation: Global status as of June 2019. 26 June 2019. Retrieved from https://ggtc.world/2019/06/26/e-cigarette-ban-regulation-global-status-as-of-june-2019/

World Health Organization. 2018 Global Progress Report on Implementation of WHO Framework Convention on Tobacco Control. 2018. Retrieved from https://www.who.int/fctc/reporting/WHO-FCTC-2018_global_progress_report.pdf  

World Health Organization. WHO Report on the Global Tobacco Epidemic. 2019. Retrieved from https://apps.who.int/iris/bitstream/handle/10665/326043/9789241516204-eng.pdf?ua=1

 

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[i] Global Center for Good Governance in Tobacco Control. E-CIGS: The future of addiction. 16 July 2018. Retrieved from https://ggtc.world/2018/07/16/e-cigs-the-future-of-addiction/ (accessed 01 September 2019).   Citing:     Reidel B, et al. (2018). E-Cigarette Use Causes a Unique Innate Immune Response in the Lung, Involving Increased Neutrophilic Activation and Altered Mucin Secretion. American Journal of Respiratory and Critical Care Medicine. Retrieved from https://www.atsjournals.org/doi/full/10.1164/rccm.201708-1590OC (accessed on 14 March 2019).     Bhatnagar A (2016). E-Cigarettes and Cardiovascular Disease Risk: Evaluation of Evidence, Policy Implications, and Recommendations. Current Cardiovascular Risk Reports. Retrieved from https://link.springer.com/journal/12170 (accessed on 14 March 2019).     Reinikovaite V, et al. (2018). The effects of electronic cigarette vapour on the lung: Direct comparison to tobacco smoke. European Respiratory Journal. Retrieved from https://erj.ersjournals.com/content/51/4/1701661.short (accessed on 14 March 2019).

[ii] Global Center for Good Governance in Tobacco Control. E-CIGS: The future of addiction. 16 July 2018. Retrieved from https://ggtc.world/2018/07/16/e-cigs-the-future-of-addiction/ (accessed 01 September 2019).     Citing:     Viswam D, et al. (2018). Respiratory failure caused by lipoid pneumonia from vaping e-cigarettes. BMJ. Retrieved from https://casereports.bmj.com/content/2018/bcr-2018-224350.full (accessed on 14 March 2019).     Byrne S, et al. (2018). E-cigarettes, smoking and health: A Literature Review Update. Australia: Commonwealth Scientific and Industrial Research Organisation. Retrieved from https://www.newsagencyblog.com.au/wp-content/uploads/2018/08/Ecigarettes-Consolidated-Final-Report240618-pdf.pdf (accessed on 25 March 2019); Chun LF, et al. (2017). Pulmonary toxicity of e-cigarettes. Am J Physiol Lung Cell Mol Physiol. Retrieved from https://www.physiology.org/doi/full/10.1152/ajplung.00071.2017  (accessed on 25 March 2019).

[iii] Global Center for Good Governance in Tobacco Control. E-CIGS: The future of addiction. 16 July 2018. Retrieved from https://ggtc.world/2018/07/16/e-cigs-the-future-of-addiction/ (accessed 01 September 2019).     Citing:     England LJ, et al. (2015) Nicotine and the Developing Human: A Neglected Element in the Electronic Cigarette Debate. American Journal of Preventive Medicine. Retrieved from https://www.sciencedirect.com/science/article/pii/S0749379715000355 (accessed on 14 March 2019).

[iv] Global Center for Good Governance in Tobacco Control. E-CIGS: The future of addiction. 16 July 2018. Retrieved from https://ggtc.world/2018/07/16/e-cigs-the-future-of-addiction/ (accessed 01 September 2019).     Citing:     Salamanca JC, et al. (2018) E-cigarettes can emit formaldehyde at high levels under conditions that have been reported to be nonaverse to users. Scientific Reports. Retrieved from https://www.nature.com/articles/s41598-018-25907-6 (accessed on 14 March 2019).

[v] Global Center for Good Governance in Tobacco Control. E-CIGS: The future of addiction. 16 July 2018. Retrieved from https://ggtc.world/2018/07/16/e-cigs-the-future-of-addiction/ (accessed 01 September 2019).     Citing:     Miao S, et al. (2016). High-Intensity Sweeteners in Alternative Tobacco Products. Nicotine & Tobacco Research. Vol. 18, Issue 11, pp. 2169–2173. Retrieved from https://academic.oup.com/ntr/article/18/11/2169/2399292 (accessed on 25 March 2019); American Chemical Society (20 August 2018). E-cigarettes can damage DNA. Retrieved from https://medicalxpress.com/news/2018-08-e-cigarettes-dna.html (accessed on 14 March 2019).

[vi] Global Center for Good Governance in Tobacco Control. E-CIGS: The future of addiction. 16 July 2018. Retrieved from https://ggtc.world/2018/07/16/e-cigs-the-future-of-addiction/ (accessed 01 September 2019).   Citing:     Global Tobacco Control. Country Laws Regulating E-cigarettes. Retrieved from https://www.globaltobaccocontrol.org/e-cigarette/domain-classification (accessed on 14 March 2019).

[vii] Global Center for Good Governance in Tobacco Control. E-cigarette ban & regulation: Global status as of June 2019. 26 June 2019. Retrieved from https://ggtc.world/2019/06/26/e-cigarette-ban-regulation-global-status-as-of-june-2019/ (accessed 01 September 2019).     See also:  World Health Organization. 2018 Global Progress Report on Implementation of WHO Framework Convention on Tobacco Control. (2018). [pdf file]. Retrieved from https://www.who.int/fctc/reporting/WHO-FCTC-2018_global_progress_report.pdf 

[viii] Ibid.

[ix] World Health Organization. Fact Sheet: Tobacco. 26 July 2019. Available at https://www.who.int/news-room/fact-sheets/detail/tobacco (accessed 02 September 2019).

See also: WHO Report on the Global Tobacco Epidemic, 2019. Geneva: World Health Organization; 2019. Licence: CC BY-NC-SA 3.0 IGO. Retrieved from https://apps.who.int/iris/bitstream/handle/10665/326043/9789241516204-eng.pdf?ua=1 (accessed 01 September 2019).

[x] See: Global Center for Good Governance in Tobacco Control. E-CIGS: Myth. Retrieved from https://ggtc.world/2018/07/16/e-cigs-myths/ (accessed 02 September 2019).     See also:     WHO Report on the Global Tobacco Epidemic, 2019. Geneva: World Health Organization; 2019. Licence: CC BY-NC-SA 3.0 IGO. Retrieved from https://apps.who.int/iris/bitstream/handle/10665/326043/9789241516204-eng.pdf?ua=1 (accessed 01 September 2019).

[xi] Global Center for Good Governance in Tobacco Control. E-CIGS: Myth. Retrieved from https://ggtc.world/2018/07/16/e-cigs-myths/ (accessed 02 September 2019).     See also: Tobacco Tactics. Foundation for a Smoke-Free World. 28 August 2019. Available at https://tobaccotactics.org/index.php?title=Foundation_for_a_Smoke-Free_World (accessed 02 September 2019).

[xii] Kalra A, Bansal P, Wilson D and Lasseter T. The Philip Morris Files. 13 July 2017. Available at https://www.reuters.com/investigates/special-report/pmi-who-fctc/ (accessed 02 September 2019. See also: Thomson Reuters. 10 year Corporate Affairs Objectives and Strategies (2014). 20 December 2017. Retrieved from https://www.documentcloud.org/documents/4333395-10-Year-Corporate-Affairs-Objectives-and.html

[xiii] Thomson Reuters. 10 year Corporate Affairs Objectives and Strategies (2014), pages 4-5. 20 December 2017. Retrieved from https://www.documentcloud.org/documents/4333395-10-Year-Corporate-Affairs-Objectives-and.html (accessed 02 September 2019).

[xiv] Thomson Reuters. 10 year Corporate Affairs Objectives and Strategies (2014), page 6. 20 December 2017. Retrieved from https://www.documentcloud.org/documents/4333395-10-Year-Corporate-Affairs-Objectives-and.html (accessed 02 September 2019).

[xv] Boseley S, Collyns D, Lamb K and Dhillon A. Supported by Vital Strategies. Tobacco: A deadly business. How children around the world are exposed to cigarette advertising. 09 March 2018. Available from https://www.theguardian.com/world/2018/mar/09/how-children-around-the-world-are-exposed-to-cigarette-advertising (accessed 02 September 2019).     See also:     Kaplan S. Juul targeted schools and youth camps, House Panel on vaping claims. The New York Times. 25 July 2019. Available from  https://www.nytimes.com/2019/07/25/health/juul-teens-vaping.html (accessed 02 September 2019).

[xvi] Global Center for Good Governance in Tobacco Control. Open Letter to Urge WHO Executive Board to Reject Foundation for a Smoke Free World (FSFW). Retrieved from https://ggtc.world/2019/01/28/an-open-letter-to-urge-who-executive-board-to-reject-fsfw/

[xvii] World Health Organization. WHO Statement on Philip Morris funded Foundation for a Smoke-Free World. 28 September 2017. Available from  https://www.who.int/news-room/detail/28-09-2017-who-statement-on-philip-morris-funded-foundation-for-a-smoke-free-world (accessed 02 September 2019).

[xviii] WHO FCTC Secretariat. WHO FCTC Secretariat’s statement on the launch of the Foundation for a Smoke-Free World. 19 September 2017. Retrieved from https://www.who.int/fctc/mediacentre/press-release/secretariat-statement-launch-foundation-for-a-smoke-free-world/en/ (accessed 02 September 2019).

[xix] World Health Organization. WHO Report on the Global Tobacco Epidemic. 2019. Retrieved from https://apps.who.int/iris/bitstream/handle/10665/326043/9789241516204-eng.pdf?ua=1 (accessed 02 September 2019).