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        At a special World Health Organization (WHO) session titled Novel and emerging nicotine and tobacco products held at the 50th Union World Conference on Lung Health, a panel of experts discussed the threat posed by e-cigarettes and heated tobacco products on global public health.

        In the session, Dr Gan Quan, Director of the Tobacco Control Department at The Union, presented on the particular challenges of regulating e-cigarettes in low- and middle-income countries. Of increasing concern is the uptake by youth, which is rising dramatically, and the substantial evidence that vaping leads young people to go on to smoke conventional cigarettes (National Academies of Science, Engineering and Medicine, 2018).

        Most of the available evidence on the extent to which e-cigarettes lead to smoking conventional cigarettes comes from the United States. In many low- and middle-income countries smoking rates are higher, cigarettes are more easily available, and smoking is still an accepted social behaviour – causing the public health community to fear an even worse risk of young people who vape to go on to smoking in these countries.

        Dr Gan Quan’s presentation also examined the lack of evidence for the effectiveness of e-cigarettes as a cessation tool, emphasising the need for stronger implementation of the evidence-based MPOWER policies recommended by the WHO Framework Convention on Tobacco Control – such as increased tobacco taxation and advertisement bans – as the best way to reduce smoking.

        “If developing countries can implement MPOWER effectively, we will see millions of smokers quit on their own” said Dr Gan Quan, pointing to the falling smoking rates in the US over the past 60 years. “MPOWER is the solution.”

        The panel recommended that countries adopt a precautionary approach with e-cigarettes, and commended the example shown by India in banning e-cigarettes outright.

        Dr Doug Bettcher, Senior Adviser, Director-General’s Office at WHO, and co-chair of the session, described the tobacco industry as having misleadingly co-opted the term “harm-reduction”, a valid public health approach in other contexts, to market new tobacco products for profit.

        The global public health community has responded with derision to the tobacco industry’s strategy to market itself as part of the solution to the tobacco epidemic, viewing this as a cynical attempt to involve itself in conversations with decision-makers and interfere in policy-making. In response, Bloomberg Philanthropies has set-up the global tobacco industry watchdog STOP, of which The Union is a partner, to support stakeholders with evidence and tools to counter the industry.

        Dr Bettcher encouraged attendees at the session to sign The Union’s Tobacco Control Pledge and commit to taking a stand against the tobacco industry. Delegates can sign the Tobacco Control Pledge at The Union booth in the Spoorthi Vedika: Community Connect space – or sign online – to become a tobacco control advocate and help end the tobacco epidemic.

         

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