The World Health Organization’s recently-released progress report on tobacco control measures represents something of a double-edged sword. While its authors rightfully praise the significant steps that countries around the world have made in clamping down on the tobacco industry and discouraging smoking among their populations, the report completely misses the mark with its unfair disavowal of the growing use of alternative nicotine products, such as e-cigarettes.

Instead of recognizing the valuable role that these products can and have played in helping smokers to transition away from cigarettes, the WHO are dogged and obdurate in their pursuit of an idealistic but unrealistic nicotine-free world. A more prudent approach would be to adopt a stance of harm reduction, including urging adult smokers—roughly half of which have already tried and failed to quit smoking— to move to less harmful alternatives such as vaping. By tarring e-cigarettes with the same brush as cigarettes, the WHO is promoting a counter-intuitive and counter-productive attitude which could ultimately serve to inflate rather than diminish the number of people who prematurely lose their lives to tobacco each year.

Noble ends, misguided means

Given the devastating effects of smoking on public health, it’s unsurprising that the WHO has been waging a war on tobacco for many years. As the progress report acknowledges, there are reasons to be cheerful about which way the wind is blowing: 5.3 billion people are now covered by at least one of the MPOWER measures recommended by the WHO, which is more than a fivefold increase since 2007.

However, the document also identifies areas in need of improvement. There are still 49 countries across the globe which have no MPOWER measures in place, with smoking rates on the increase in some developing nations. The pandemic has only exacerbated the issue as well. With smokers up to 50% more vulnerable to early death from the coronavirus than non-smokers, it’s not hard to fathom why the WHO has launched a year-long campaign in 2021 aimed at helping at least 100 million people stub their cigarettes out once and for all.

Although initiatives such as raising tax and restricting advertisements on tobacco products have shown remarkable results, the WHO’s demonization of smoking alternatives – including vaping products like e-cigarettes – represents a serious misstep by the body. Condemning these products neglects the fact that vaping has been found to be 95% safer than smoking by no less an authority by Public Health England (PHE). In light of 7 million annual deaths caused by smoking, vaping is an alternative to cigarette use that can hardly be ignored. As Professor Peter Hajek, from Queen Mary University of London, emphasized in the wake of the WHO report, “smoking-related cancer, heart disease, and lung disease will eventually disappear as smoking is made obsolete by much less risky nicotine products that do not include combustion. Given the large benefits this will bring to public health, it is paradoxical that the WHO has adopted a strident anti-vaping stance which risks preventing this transition.”

Stance not supported by scientific evidence

As well as perpetuating the erroneous idea that vaping is just as harmful as smoking – a misguided perception which, unfortunately, many Europeans have adopted—the WHO has also alleged that vaping is a “gateway” activity which encourages young people to smoke. This suggestion has simply not been borne out by the available research—in fact, a recent study by public health researchers at Yale found that banning the flavoured vaping liquids which help convince many smokers to switch to e-cigarettes may have led young people to increase their tobacco smoking instead.

Given the serious long-term health consequences of picking up a smoking habit, any regulation that might push young people towards combustible tobacco use is fatally flawed. Nevertheless, the WHO remains steadfast in their opposition to vaping—something which is troubling given the organisation’s international influence.

EU unfortunately susceptible to WHO scepticism

This inability to distinguish and differentiate between smoking and vaping products only serves to conflate the issue and perpetuate the false perception that both are equally harmful. That outlook is particularly pronounced in the EU, where countries like the Netherlands are ploughing on with plans to implement strict e-cigarette regulations (such as a ban on flavoured products) despite strong public opinion and mounting scientific evidence against these measures. Tellingly, most EU officials appear tragically unaware about the relative risk profile of alternative nicotine products.

That lack of awareness – coupled with the unattainably idealistic aim of stamping out nicotine use altogether – is not just surprising, it is outright hazardous to human health. Viewing e-cigarettes in the same light as combustible tobacco products will only encourage greater regulation and diminished uptake of the former, all the while simultaneously safeguarding the longevity of the latter.