Harry's Blog 115
Invisible Numbers – the WHO Hides the Evidence for Tobacco Harm Reduction

The WHO has just published Invisible numbers: The true extent of noncommunicable diseases and what to do about them. I’m not sure where the WHO gets the idea that the statistics on death and disease from cardiovascular and respiratory diseases and cancer are ‘invisible’. There is a wealth of data out there from national and international public health, medical and academic sources, including the Global Burden of Disease annual reports and the WHO’s own International Agency for Research on Cancer. [Read More]

Resource highlights
2018-12-31 , Submission deadline
IJERPH is now accepting submissions for a special issue on Tobacco Harm Reduction, on research that advances our understanding of the potential place of tobacco harm reduction strategies within a comprehensive approach to reducing the burden of smoking related disease, and that will assist policy makers to determine what level of regulation is most appropriate for potential reduced risk products.
2018-01-19 , vapetrotter.com
A GLOBAL RESOURCE FOR VAPE STORE LOCATIONS AND TRAVEL INFORMATION
37,191 vape stores in 106 countries

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Tuesday, 04 October

The WHO has just published Invisible numbers: The true extent of noncommunicable diseases and
what to do about them.


https://www.who.int/teams/noncommunicable-diseases/invisible-numbers


I’m not sure where the WHO gets the idea that the statistics on death and disease from
cardiovascular and respiratory diseases and cancer are ‘invisible’. There is a wealth of data out there
from national and international public health, medical and academic sources, including the Global
Burden of Disease annual reports and the WHO’s own International Agency for Research on Cancer.


So, not invisible, but certainly worth highlighting again. And the figures make sober reading. The four
major noncommunicable diseases (NCDs) are cardiovascular diseases (heart disease and stroke),
cancer, diabetes, and chronic respiratory diseases. Over three-quarters of all deaths worldwide are
caused by NCDs. Seventeen million people die from an NCD before the age of 70.
The key risk factors are listed as tobacco use, harmful use of alcohol, diet, and lack of physical
activity linked to obesity. And as with most global metrics of poor health, 86% of NCD deaths occur
in lower- and middle-income countries (LMICs).


The whole thrust of the report is to restate the importance of achieving a 33% reduction in NCDs by
2030 in line with the Sustainable Development Goals. Without naming them, the WHO states that in
2022, “only a handful of countries” are on track to meet this target. Hard to imagine that the
situation will improve much in the next eight years given the current state of the world economy and
the health fall-out from the growing devastation caused by climate change.


In reality, the WHO can do little except to exhort individual governments to do more – invest in
health care provision, restrict advertising on junk food, tobacco and alcohol, encourage people to do
more exercise, and push for a collective investment of $140bn US to make a difference. But will it?


Take the idea of more physical exercise. Only the richest countries can afford to host an Olympic
Games. Host cities spent millions and put themselves in debt on the legacy promise of shiny new
sport facilities for local communities. Measurable impact on increased take-up of daily exercise as a
result – zero. New stadiums fall into disrepair, while, for example, local authorities in England have
been selling off school playing fields for housing development. At the other extreme, I can’t imagine
that young people in the poorest countries walking miles to school or parents taking daily long hikes
for fresh water need more exercise.


The impact of poor diet is not just junk food (which is causing a rise in cancers among younger age
groups) – but no food. The war in Ukraine has shown how fragile the world’s food supply chain is.


The report majors on aspirations like ‘Leading from the top’; ‘Set the right priorities’; and ‘Choose
the right policies and interventions’. Maybe those in charge of WHO tobacco control policies need to
ponder on these, because currently they are failing in all respects to offer real leadership in tackling
death and disease from smoking.


Let’s go back to the list of WHO key risk factors – tobacco and harmful use of alcohol. What’s the
message here? Agreed that moderate use of alcohol is not harmful (but only in respect of NCDs with
no reference to the damage caused by drunk driving, domestic violence and public disorder).

What about tobacco? There may be no safe moderate use of combustible tobacco, but the WHO
knows full well, the welter of independent evidence shows that whether as tobacco or
nicotine, the use of vaping, heated tobacco products, safer oral products such as snus or
nicotine pouches carries none of the attendant NCD risks of smoking.


The WHO clouds the issue when it states that tobacco is the leading cause of preventable NCD
deaths. It is smoking, which causes virtually all the 8 million tobacco-related deaths each year. The
WHO response is to trumpet the fact that some five billion people are ‘protected’ from smoking as
recorded by its MPOWER evaluation tool. It is delusional to imagine that smoking bans, plain
packaging and warning labels ‘protects’ anybody. High tax may have some impact in reducing
prevalence, but this just hits the poorest people who are likely to turn to readily available illicit
supplies. These are just laws on the statute book which in many countries are simply unenforceable.


If the WHO was serious about tackling this most damaging source of NCD, it would be taking
proactive steps to encourage countries to introduce risk proportionate legislation to promote uptake
of safer products. If countries made products accessible through legislation, then the industry – big
or small – could be left to determine which products were appropriate and acceptable for different
countries and price them accordingly. And all at no cost to governments, many of whom in LMICs
have enough health problems to worry about as the WHO report points out.


However, the WHO ignores all the evidence that could help spark a revolution in public health,
instead focusing on an ideological war against nicotine funded by Bloomberg Philanthropies whose
CEO makes this pronouncement in the report:


“Bloomberg Philanthropies will continue expanding our efforts to help more cities and countries
take actions that will stop preventable deaths, and ensure longer, healthier and happier lives for
all.”


For those millions looking to switch from smoking but unable to access or afford safer products, this
must read like a sick joke with an emphasis on sick.

Monday, 01 August

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Tuesday, 29 March

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Wednesday, 17 November

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Friday, 28 May

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Thursday, 09 June

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Thursday, 25 November

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Thursday, 16 September

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Wednesday, 25 August

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Monday, 12 April

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