Professors Robert Beaglehole and Ruth Bonita say WHO and the FCTC Conference of Parties reject harm reduction. Credit: The Lancet.
Two former World Health Organization (WHO) officials said WHO’s Framework Convention on Tobacco Control (FCTC) is not working and the number of tobacco users globally has barely changed since FCTC began.
“Tobacco control is not working for most of the world,” wrote Professor Robert Beaglehole and Professor Ruth Bonita in a correspondence titled “Tobacco control: getting to the finish line” published in The Lancet on May 14. “Four out of five of the world’s smokers are in low-income and middle-income countries. In these countries where most of the eight million deaths caused by tobacco occur each year, rates of tobacco use are falling only slowly,” they said.
According to Beaglehole and Bonita, in these low- and middle-income countries where most of the eight million deaths caused by tobacco occur each year, rates of tobacco use are falling only slowly. Only 30% of countries are on track to achieve the WHO adult tobacco use target of a 30% reduction in prevalence by 2030, and most countries are not on track to achieve the Sustainable Development Goal 3.4 for non-communicable diseases.
“FCTC is no longer fit for purpose, especially for low-income countries," they said. "Neither WHO nor FCTC are grounded in the latest evidence on the role of innovative nicotine delivery devices in assisting the transition from cigarettes to much less harmful products." Beaglehole and Bonita believe the missing strategy in WHO and FCTC policies is harm reduction.
“Unfortunately, WHO and the FCTC Conference of Parties reject harm reduction,” they added. “This opposition is not grounded in 21st century technological advances, and is unduly influenced by vested interests who promote nicotine abstinence.
Beaglehole was director of WHO's Department of Chronic Disease and Health Promotion from 2004 to 2007. Bonita was director of surveillance in the WHO's Noncommunicable Disease Cluster from 1999 to 2005. They are both currently professor emeritus of the University of Auckland.