By Tomás Sánchez, president of the Panamanian Tobacco Harm Reduction Association
It is the main body, worldwide, for discussion and decision-making on tobacco control policies, but everything is done behind closed doors without the participation of the main actors in this issue: the citizens.
This is how the Conference of the Parties (COP) of the Framework Convention on Tobacco Control (FCTC) of the World Health Organization (WHO) works – a body that over the years has become a kind of brotherhood that vetoes the participation of genuine groups of organized civil society, producers, doctors, industry, individuals and even journalists who are based on available information that is not biased or preconceived such as that used by those who participate in this global forum.
In recent years it has become increasingly clear that at COP there is no room for dissent or debate based on scientific evidence or the reality of each country. Only those who abide by or share the line dictated by the COP have space. But in order not to appear sectarian, which borders on authoritarianism, they have established a preselection process where they themselves define and decide who participates in the COP sessions.
In fact, at COP they do not consider the abundant new variety of scientific evidence around alternatives to cigarettes, and they do not take into account experiences such as those of the United Kingdom, where they have distributed free vaping starter kits to one million smokers in order to encourage them to quit smoking.
Nor does it consider the result of research from Brunel University of London, which has shown that if 50% of adult smokers in England switched to reduced risk products, the health system could save more than $500 million annually.
In this regard, a study published in the British Journal of Healthcare Management also analyzed data related to smoking as a cause of death, as well as the risk of developing diseases associated with this habit. It was detected that, if 50% of smokers manage to migrate to reduced risk alternatives, hospital admissions would be reduced by 13%, in a country that had an estimated of 500,000 hospital admissions related to smoking between 2019 and 2020.
The savings would also be significant for social security and care spending due to smoking, which together amount to more than double the cost of smoking to that country’s National Health Service (NHS), which amounts to more than $2.5 billion annually.
In South Africa, a social analysis called “Mzansi Make the Switch” revealed that reduced risk products such as vaporizers can be an effective tool to reduce smoking.
More than 40% of participants in this social analysis were smoke-free after 12 weeks of using vaping devices, and 79% of those who continued smoking while vaping reduced their cigarette consumption.
This is just some of the evidence that supports the need for the COP to promote a harm reduction strategy based in scientific evidence and the reality of each country.
20 years after the adoption of the Framework Convention on Tobacco Control, it has been demonstrated that the strategy promoted by the World Health Organization is not correct. This is evidenced by the WHO’s own figures, which reflect that, in 2020, 22.3% of the world’s population used tobacco: specifically, 36.7% of men and 7.8% of women.
While tobacco consumption has increased, cigarette smuggling has also grown, which impacts not only the health of consumers, but has other implications such as the rise of criminal organizations that have established routes to smuggle cigarettes.
In the case of Panama, 92.1% of the cigarettes consumed come from illicit trade, which reflects an increase of 12.2% between 2019 and 2022, according to the results of the latest Illegal Cigarette Market Study carried out in the country in 2022 by Nielsen (a global leader in audience knowledge, data and analytics).
In short, it is a reality: the strategies of the Framework Convention on Tobacco Control of raising taxes, legislating for smoke-free zones, imposing warnings on packs, or prohibiting their advertising, have proven to be insufficient – not only in Panama but at the international level.
It is time to look for realistic solutions but with the participation of all sectors, all actors – not a “brotherhood” that, based on the evidence we all have available, has failed in its anti-smoking strategy. We must take a turn focused on the citizens and the reality of each country. Let’s not allow a few to compromise the future of everyone.
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