Letter To WHO: Do Not Classify Electronic Smokes As Cigarettes
May 29, 2014

Letter To WHO: Do Not Classify Electronic Smokes As Cigarettes

Lawrence LeBlond for redOrbit.com - Your Universe Online

On May 27, the World Health Organization (WHO) released a statement calling for governments to raise taxes on tobacco products to encourage users to quit and stop others from becoming addicted to the deadly habit. The release followed 2012 data by the UN health agency that increasing tobacco taxes by 50 percent could reduce the global number of smokers by 49 million within three years and could save 11 million lives.

Separately, the WHO has also pushed to get electronic cigarettes reclassified as the same as regular cigarettes, claiming that they are as much a danger to health as regular tobacco products. It is this commitment that is now drawing worldwide criticism.

More than 50 leading scientists from 15 countries have written a letter to the WHO’s Director-General, Margaret Chan, to reconsider its intention to classify e-cigarettes as the same as regular cigarettes, warning the agency is missing the point on e-cigarettes, which have already drastically reduced smoking and illness and death associated with it.

The letter came following the public release of a leaked document from a Framework Convention on Tobacco Control (FCTC) preparatory meeting indicating the WHO considers e-cigarettes a “threat” to public health and plans to champion their removal as an accessible alternative to regular tobacco use. This intent to sideline e-cigarettes is set to take place at the upcoming FCTC meeting in Moscow in October.

However, the 53 signatories of the letter argue that tobacco harm reduction products could play a significant role in meeting the UN’s goal of reducing non-communicable diseases by 2025. They maintain that e-cigarettes and other safe nicotine products are part of the solution, rather than part of the problem.

Currently, the FCTC does not differentiate between the risks of different nicotine products. By applying the FCTC measures to e-cigarettes, they would fall under the same category as tobacco products and result in advertising bans, smoke-free legislation and higher taxes and large health warnings – all of which would be aimed to reduce their availability, attractiveness and acceptability, the signatories said.

Furthermore, they warn that the excessive restrictions on lower risk products will have the unintended consequence of protecting cigarettes from competition from less hazardous alternatives.

“If the WHO gets its way and extinguishes e-cigarettes, it will not only have passed up what is clearly one of the biggest public health innovations of the last three decades that could potentially save millions of lives, but it will have abrogated its own responsibility under its own charter to empower consumers to take control of their own health, something which they are already doing themselves in their millions,” said Professor Gerry Stimson, Emeritus Professor at the Imperial College in London, a signatory to the letter, and organizer of the upcoming Global Forum on Nicotine.

The WHO estimates that stricter tobacco rules and regulations, which include higher taxes, could prevent up to one billion tobacco-related premature deaths in the 21st century alone. Tobacco control policy over the past 30 years has successfully communicated the harms associated with smoking, has encouraged measures to reduce smoking, and has drastically cut smoking in the developed world – although smoking is still increasing in many parts of the developing world.


The signatories know it will be a tough uphill climb to sway the mindsets of WHO and public health leaders who have been successful in bringing international tobacco control to the forefront over the past decade. But, they maintain they have to try.

The letter argues that WHO and FCTC must recognize that not all tobacco products are the same with regard to risk. They should recognize that e-cigarettes have been instrumental in significantly reducing death and disease when users switched from regular tobacco products.

“For the WHO to suggest that e-cigarettes are as risky as other tobacco products would send an erroneous and bleak message to the millions of current e-cigarette users who have used them to quit smoking,” said Robert West, also a signatory to the letter and Professor of Health Psychology and Director of Tobacco Studies at University College in London. “It would discourage smokers from trying them and we would miss out on a major opportunity to reduce smoke related deaths globally.”

He told the BBC that e-cigarettes should be “regulated appropriate to what they are [and that they are] orders of magnitude safer [than tobacco cigarettes].”

People smoke for the nicotine, but die from the smoke. With e-cigarettes, smokers can get their nicotine fix without the worry of death and disease associated with the harmful smoke they and other around them inhale, getting a deadly concoction of tar and toxic gases polluting their lungs.

“E-cigarette use has been a consumer led revolution and grown as a bottom-up public health initiative that could save millions of lives”, said John Britton, Professor of Epidemiology at the University of Nottingham, UK. “It has moved at a speed that shows just how much smokers want and will choose nicotine products that don’t kill. I hope the WHO and all public health decision makers can recognize and harness the health opportunities that e-cigarettes can provide.”

In an interview with the BBC's Jane Dreaper, a WHO spokesman said: "WHO is currently working on recommendations for governments on the regulation and marketing of e-cigarettes and similar devices. This is part of a paper that will be submitted to the parties of the WHO Framework Convention on Tobacco Control later this year.”

"We are also working with national regulatory bodies to look at regulatory options, as well as toxicology experts, to understand more about the possible impact of e-cigarettes and similar devices on health," the spokesman added.

The British Medical Association is also on the side of WHO and FCTC, calling for stronger regulation of e-cigarettes in the UK.

Dr Vivienne Nathanson, the BMA's director of professional activities, told the BBC there is evidence that kids who have never smoked are now beginning to use e-cigarettes, many being influenced by advertising campaigns.

"Rather like cigarettes in the 50s and 60s, we really need to look at that and, I believe, ban it (advertising), to stop them advertising in a way that attracts children," Nathanson noted.

The issue of children using electronic cigarettes is also drawing concern from Prof John Ashton, president of the Faculty of Public Health.

"We need to weigh up the benefits of fewer people smoking against the risk of electronic cigarettes leading to more people starting to smoke, particularly children," he told the BBC.

Still, the health community has been divided on the subject of whether e-cigarettes are safer than the real thing, noted Prof Martin McKee, of the London School of Hygiene and Tropical Medicine.

"While the signatories to this letter are clearly supportive, the World Health Organization, correctly, bases its decisions on the best available evidence," noting it would be “premature” for them to advocate the use of e-cigarettes until their safety is well-established.

The letter's signatories argue that WHO’s targets for reduction of tobacco consumption should be aligned with the ultimate goal of reducing disease and premature death. By pushing for e-cigarettes to be labeled as the same as regular tobacco products it will backpedal all the progress that has been made on reducing high-risk tobacco use.

Instead of attacking e-cigarettes, the signatories suggest WHO officials promote them in order to meet global targets on reducing disease and death.