The World Health Organization (WHO) estimates that smoking kills nearly 6 million people per year worldwide, making it the largest cause of preventable premature death. It is estimated that there are more than 300 million people smoke in China and in 2010 alone nearly one million people in China died from causes related to tobacco smoking. If the trend continues, the death-toll will double to two million people by 2030. In Hong Kong, 600,000 smokers still light up and are laid low by the practice every year.
But there may be a saviour.
Smoking causes a wide range of non-communicable diseases, including lung cancer, chronic obstructive lung disease, peripheral arterial disease, and heart disease. These diseases are caused by regular, long-term inhalation of smoke from burnt tobacco. That smoke contains around 7,000 chemicals, over 200 of which are carcinogens. Approximately half of all smokers will die prematurely as a result of their habit.
In an attempt to reduce this enormous toll, the WHO established the Framework Convention on Tobacco Control (FCTC). To date, the FCTC has focused on policies that seek to reduce demand for and supply of tobacco products, or simply promulgated the idea that smokers either “quit or die.” Yet, since the FCTC came into force in 2005, the number of smokers has increased, especially in China and other developing countries that were the FCTC’s primary target.
A real solution
Clearly, there is a need to supplement these policies with a more open-minded approach to look at emerging non-combustible products that offer smokers less harmful alternatives to cigarettes. Unfortunately, the FCTC seems resistant to such products, in spite of compelling evidence that they have enabled millions of people to stop smoking.
The key principle to these products is the absence of combustion and new technologies have emerged that offers smokers ways to retain the rituals and pleasures of smoking with far fewer risks as a result. One such technology is the “electronic cigarette,” first developed by a Chinese pharmacist Hon Lik in 2003, which has some of the look and feel of a cigarette and delivers nicotine, with only a tiny fraction of the number and amounts of toxic chemicals. The device works by heating a solution of nicotine mixed with propylene glycol and flavors, to create a vapor.
The vapor from e-cigarettes, personal vaporisers (the name given to larger, more powerful devices) contains very low levels of carcinogens and other harmful chemicals. Even nicotine itself is largely benign – contrary to widespread misconceptions. As the British Royal College of Physicians put it recently, vaping “is at least 95 per cent safer” than smoking.
Moreover, vape products have proven an effective aid to quitting. In the past five years, use of vape products has exploded in many countries, especially the US, UK, France and Malaysia. At least ten million people have quit smoking by switching entirely to vaping and millions more have dramatically reduced the amount that they smoke. That’s why in the UK, the National Health Service now encourages doctors to recommend that patients who smoke should switch to vaping.
This has enormous potential to reduce the burden of smoking-related disease in Asia. Given individual differences and cultural norms, experimentation is likely to play an important part in the process of discovering which products are most effective alternatives to smoking. It is therefore very important that governments do not impose undue restrictions on the development and use of these products by adult smokers.
Unfortunately, instead of embracing these products as harm reduction tools, the WHO has been pushing for stringent regulation. Had such regulation been in place in the UK and US, it is unlikely that the products would have developed much beyond the original electronic cigarette and quality, safety and uptake would have been low.
Many of the problems with the FCTC stem from the fact that it violates all the precepts of good governance, especially transparency. The two most recent Conferences of the Parties (COPs) of the FCTC, in Seoul in 2012, and in Moscow in 2014, all journalists were thrown out of the public gallery and the meetings were held in secret. Moreover, there is essentially no participation by representatives of many affected groups, including users of tobacco and vape products, vendors, and farmers. Participation by IGOs has also been restricted; even Interpol has been denied Observer status despite its expertise in combating illicit trade in tobacco, a key topic covered by the Convention.
According to an internal documents obtained by the Huffington Post, FCTC inclined to “ensure the exclusion of representatives and officials from…fully or partially state-owned tobacco industries, including state tobacco monopolies.” It would imply that countries such as China, Cuba, Egypt, Bulgaria, Thailand and even the host, India, could face difficulty in getting their delegates approved to attend the event and vote on tobacco control issues.
If the WHO’s FCTC is genuinely committed to the “right to health”, it should change the approach to vape products, recognizing their life-saving potential and listen to those who are taking control of the things that determine their health, and to those who are helping them to do so. At the very least, it should respect nations’ sovereign authority to develop their own public health policy that acknowledges and reflects the conclusions from many health experts whose research shows that these vaping innovations can, and do, save lives.
About Julian Morris
Julian Morris is Vice President for Research at Reason Foundation. Julian graduated from Edinburgh University in 1992 with an MA in economics. He has an MSc in environment and resource economics from University College London, an MPhil in land economics from Cambridge University, and a law degree from the University of Westminster. Julian is the author of dozens of scholarly articles on the relationship between institutions, development and environmental protection, and the editor of several books, including Sustainable Development: Promoting Progress or Perpetuating Poverty (Profile Books, 2002). Prior to joining Reason, Julian was Executive Director of International Policy Network, which he cofounded. Before that, he ran the environment and technology programme at the Institute of Economic Affairs.
About Reason Foundation
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