Johannesburg - When the Ninth Conference of the Parties (COP9) to the World Health Organization’s Framework Convention on Tobacco Control (WHO FCTC) kicks off later this month, there will be an important voice missing at the talks: members of the vapour products industry.
While it’s bad enough that an industry that’ll be directly affected by the convention’s recommendations doesn’t have a seat at the table, its exclusion could also have seriously detrimental consequences for tobacco harm reduction, especially in lower and middle-income countries.
That was the overwhelming message to come out of a webinar this week hosted by the Vapour Products Association of South Africa (VPASA), addressing the industry’s position on some of the topics that will be covered at the conference.
With many countries relying on the recommendations of the FCTC to set out their laws and regulations around smoking and smoking alternatives, COP9 has potentially massive ramifications. Historically, however, these recommendations have been prohibitionist in nature, undermining the role vaping and no-smoke products can have when it comes to harm reduction.
“The outcomes of COP9 will not be balanced,” said VPASA CEO Asanda Gocyi. “Decisions will be made on behalf of an industry which does not have a seat at the table.”
This sentiment was backed up by John Dunne, Director of the United Kingdom Vaping Industry Association (UKVIA).
“Despite the treaty’s commitment to harm reduction, the WHO and FCTC have never embraced e-cigarettes but have instead called for excessive regulations,” he said. “In their relentless opposition to vaping and other reduced-risk products, the FCTC Secretariat and the COP have become a threat to global public health.”
Clive Bates,director of Counterfactual, a public interest policy consulting and analytical advocacy organisation pointed out that this approach flies in the face of compelling evidence that vaping and reduced-risk products have significant public health benefits.
“There’s a bunch of groupthink in the tobacco control world,” he said, pointing out that WHO had given one of its top awards to an Indian doctor who spearheaded the banning of e-cigarettes in that country.
He also noted many of the reasons given by the FCTC for taking this prohibitionist approach, including fears that the manufacturers of vaping products target teenagers and that it’s a gateway to cigarette smoking.
“There is no evidence for the gateway effect,” he said, adding that, “the money is to be made from committed smokers switching to vaping and e-cigarettes rather than from attracting new customers.”
Instead of taking the approach they have, Dunne suggests that the FCTC should look to the example of the UK, which has embraced vaping as a harm reduction tool. In fact, there are major trials within the NHS around providing vaping products to smokers who struggle to quit.
“Above all, the argument around vaping and reduced risk products is one of public health and the UK has a clearly stated position that vaping is 95% safer than combustible tobacco,” he said. “In recent years, the UK has very successfully integrated vaping into its public health policies on tobacco harm reduction.”
For an example of the dangers of moving from a harm reduction approach to the kind of prohibitionist approach espoused by the FCTC, Māori (New Zealand indigenous) behavioural scientist Dr Marewa Glover points to what’s happened in New Zealand.
“Over the last three decades, tobacco control has become more and more prohibitionist in its focus,” she said.
An example of this can be seen in the restrictions now placed on vaping, including heavily restricting the flavours available at mainstream retailers and insisting that specialist vape retailers have brick-and-mortar stores.
“The government’s purpose has moved from reducing harm to preventing normalisation of vaping,” she said. “As a result, there are more barriers to switching for people who smoke and lower levels of access to harm-reduction products for people in rural and remote areas.”
Dr Kgosi Letlape, co-founder of the Africa Harm Reduction Alliance (AHRA) says South Africa may face even more significant issues as it continues to treat vaping and reduced harm products as equivalent to cigarettes by law.
This, he believes, does nothing but protect traditional cigarette manufacturers.
“We must embrace smokers and say they are humans too and don’t deserve to die,” he said, “As a doctor, I tell patients ‘If you smoke, quit. If you can’t quit, switch’. That should also be the mindset of legislators and regulators.”
He also pointed out that harm-reduction products have a wider public health benefit, too.
“Replacement products don’t just benefit the user, they benefit those around them,” he said.
Ideally, he added, there should be a continuum of risk reduction products, with options accessible to people of all income levels.
In the meantime, all the speakers concluded, South Africa would do best not to simply follow the recommendations of WHO and the FCTC but to act in its own national interest.
As Bates pointed out,“the prohibitionist approach is completely baseless, completely counterproductive, and completely against the best interests of public health”.