Health advocates called on the World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC) delegates to explore other solutions as the current strategies were found inadequate to abate the global smoking problem.
Jeffrey Smith, a senior fellow at American think tank R Street Institute, in a study titled “The Impact of Cultural Pressures on Tobacco Harm Reduction Efforts in Southeast Asia”, concluded that the FCTC’s current focus on price increases, advertising bans and smoke-free space restrictions has had limited impact, particularly in Southeast Asia, where cultural and economic factors complicate implementation.
“These efforts are not enough. This becomes especially apparent when looking at the Southeast Asian region of the world, where the measures that the FCTC promotes fail to align with individual countries’ needs—in large part because of the way tobacco is tied to that region’s political, cultural and financial circumstances,” Smith said.
Dr. Lorenzo Mata, president of the Philippine non-profit advocacy group Quit For Good, said Smith’s study is timely, as delegates from more than 180 countries attend the 10th Conference of the Parties (COP) of the World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC) in Panama this week.
“As a result of this review, we conclude that a single approach to tobacco control and THR policy does not seem to yield the most effective outcomes for all countries. Instead, individualized, country-and-culture-specific approaches, built on key principles of THR, are needed,” said Smith.
Mata suggested that the WHO FCTC delegates explore the tobacco harm reduction (THR) principles if they really intend to make a dent on the global smoking epidemic. THR means offering smokers less harmful alternatives to cigarettes, like vapes, heated tobacco and oral nicotine products so they would not be exposed to smoke.
Mata agreed with Smith that granting adult smokers access to affordable, reduced-risk nicotine products could save millions of lives and improve global public health outcomes. He said the WHO FCTC delegates should consider science-based innovations, such as THR, to tackle the global smoking epidemic and prevent smoke-related deaths.
Studies suggest that alternatives like electronic nicotine delivery systems (ENDS) and heated tobacco, which are smoke-free, are “definitely less harmful” than traditional cigarettes.
Smith noted that more than 8 million people die annually from tobacco-related diseases, with 80 percent of them in low- and middle-income regions. Southeast Asia alone witnesses 1.6 million lives lost to smoking each year.
The COP 10 held in Panama City from February 5 to 10 will discuss crucial topics like the availability of “novel and emerging tobacco and nicotine products.”
Mata and Smith believe that THR, which encourages switching to potentially less harmful alternatives like ENDS and heated tobacco, could significantly reduce deaths and disease. They point to countries like Sweden, the UK and Japan, which have seen success with THR.
Japan, in particular, saw a substantial decline in smoking rates from 33 percent in 2000 to 20 percent in 2020, primarily due to the introduction of heated tobacco.
Smith said the Philippines, which signed the FCTC treaty in 2005, also took a different approach when it signed the Vaporized Nicotine and Non-Nicotine Products Regulation Act into law in 2022. The law allows for the regulation of ENDS and other reduced-risk products to protect the health of Filipino adults and youth.
“The Filipino population has access to several forms of reduced-risk nicotine products, including ENDS [the most prevalent], heated tobacco and snus. A combination of education, combustible tobacco taxation and increased accessibility of reduced-risk products provides an environment for change that can work for the Filipino population and improve health significantly, though it will take some time for the impact of these measures to be realized,” said Smith.
THR experts believe that increasing access to and acceptance of these products could help mitigate the death and disease burden associated with cigarette smoking. Smith said that while not risk-free, these alternatives have been shown to carry notably less risk, up to 95 percent compared to traditional combustible products.
Mata said the Philippines’ “Vape Law” could even be a model for other countries, allowing smokers access to potentially less harmful options. He urged the FCTC to consider harm reduction principles and “allow smokers access to safer alternatives,” potentially saving millions of lives globally.
“After conducting studies ourselves, we were convinced that the use of vaporized nicotine and non-nicotine products, was definitely less harmful [than smoking combustible cigarettes] and could be considered a pragmatic middle ground to which we should bring our current adult cigarette smokers,” said Mata.
“The Vape Law reflects the government’s position that innovative smoke-free products, proven by scientific research to be far less harmful than traditional cigarettes, should be regulated as options for smokers who wouldn’t quit otherwise,” he said.
Smith, in his article, reviewed tobacco production/use, tobacco control approaches dictated by the FCTC and the implementation of THR strategies in Southeast Asia to illustrate culturally sensitive approaches and their impact on public perception and health.