KATHMANDU, JULY 28
Many countries are making progress in the fight against tobacco, but a new World Health Organisation report shows some are not addressing emerging nicotine and tobacco products and failing to regulate them.
According to the new data presented by the report on electronic nicotine delivery systems, such as 'e-cigarettes', these products are often marketed to children and adolescents by the tobacco and related industries that manufacture them, using thousands of appealing flavours and misleading claims about the products.
WHO is concerned that children who use these products are up to three times more likely to use tobacco products in the future.
The Organization recommends governments to implement regulations to stop non-smokers from starting to use them, to prevent renormalization of smoking in the community, and to protect future generations.
"Nicotine is highly addictive. Electronic nicotine delivery systems are harmful, and must be better regulated," said Dr Tedros Adhanom Ghebreyesus, WHO Director-General, "Where they are not banned, governments should adopt appropriate policies to protect their populations from the harms of electronic nicotine delivery systems, and to prevent their uptake by children, adolescents and other vulnerable groups."
Currently, 32 countries have banned the sale of electronic nicotine delivery systems (ENDS). A further 79 have adopted at least one partial measure to prohibit the use of these products in public places, prohibit their advertising, promotion and sponsorship or require the display of health warnings on packaging. This still leaves 84 countries where they are not regulated or restricted in any way, claimed the WHO report.
Michael R. Bloomberg, WHO Global Ambassador for Noncommunicable Diseases and Injuries and founder of Bloomberg Philanthropies, said "More than 1 billion people around the world still smoke. And as cigarette sales have fallen, tobacco companies have been aggressively marketing new products – like e-cigarettes and heated-tobacco products – and lobbied governments to limit their regulation. Their goal is simple: to hook another generation on nicotine. We can't let that happen."
Dr Rüdiger Krech, Director of the Health Promotion Department at WHO, highlighted the challenges associated with their regulation. "These products are hugely diverse and are evolving rapidly. Some are modifiable by the user so that nicotine concentration and risk levels are difficult to regulate. Others are marketed as 'nicotine-free' but, when tested, are often found to contain the addictive ingredient. Distinguishing the nicotine-containing products from the non-nicotine, or even from some tobacco-containing products, can be almost impossible. This is just one way the industry subverts and undermines tobacco control measures."
The proportion of people using tobacco has declined in most countries, but population growth means the total number of people smoking has remained stubbornly high. Currently, of the estimated 1 billion smokers globally, around 80% of whom live in low- and middle-income countries (LMICs). Tobacco is responsible for the death of 8 million people a year, including 1 million from second-hand smoke, WHO said.
While ENDS should be regulated to maximize protection of public health, tobacco control must remain focused on reducing tobacco use globally. MPOWER and other regulatory measures can be applied to ENDS, WHO recommended.
The eighth WHO Report on the global tobacco epidemic launched on Tuesday also summarised national efforts to implement the most effective demand reduction measures from the WHO Framework Convention on Tobacco Control (WHO FCTC) that are proven to reduce tobacco use. These measures are known collectively as "MPOWER".