Smoking, experts: "The goal of harm reduction is still far away"

At the Global Forum on Nicotine 2025, a review of the 20 years of the WHO Framework Convention on Tobacco Control (FCTC)

Reducing the harm caused by smoking remains a difficult goal to achieve. The experts present at the Global Forum on Nicotine (GFN), the international conference taking place in Warsaw, which brings together experts from all over the world to discuss the role of nicotine-containing products in helping smokers to abandon traditional cigarettes, are taking stock of the effectiveness of the World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC), the international treaty for public health, twenty years after its entry into force (2005).

“When you look at the success of any treaty, the three key things to look at are legal effectiveness, political effectiveness and objective and effective effectiveness,” says Jeannie Cameron, founder and CEO of JCIC International Consultancy, which specializes in tobacco harm reduction policy advocacy. “You could say that this treaty has certainly fulfilled its legal obligations,” Cameron reflects. “In the first year of negotiations, 168 countries have signed and ratified or acceded. On political effectiveness, you could say that most countries have acted in terms of advertising bans, public smoking bans, packaging and labeling and taxation. But those are all things that have not affected the harm reduction aspects.”

"The FCTC claims to want to control not only tobacco smoke but also all the alternatives that could offer alternatives for smokers," says David Khayat, Professor of Medicine and Medical Oncologist at the Bizet Clinic in Paris. For Derek Yach, an expert in global public health policy and former president of the Smoke-Free World Foundation, the applicability of a treaty like the FCTC also depends on the country it is aimed at. "The thought and intent of the treaty were great but where there are no resources, no expertise, no political will and no organizational capacity, very little can be done," he emphasizes. "There is a gap between low-middle income countries and high-middle income countries in terms of investment in tobacco harm reduction research." In fact, in relation to low-income countries, the problems are also linked to "the lack of capacity to independently evaluate their own data", notes Tikki Pangestu, a senior academic at a leading Asian university and director of research and cooperation policy at WHO from 1999 to 2012. "I come from Indonesia - he adds - where 70%, 2 out of 3 adult men, smoke traditional cigarettes. This data represents the inability to evaluate the evidence. Furthermore, there is a lack of research at the local level", he concludes.