Michael Bloomberg is the WHO Global Ambassador for Noncommunicable Diseases and Injuries. He says in the WHO press release announcing the summit, “Noncommunicable diseases and injuries are leading causes of death around the world, but they are preventable, and the Partnership for Healthy Cities is tackling them with the kind of urgency we need more of.”

José Luis Castro, President and CEO of Vital Strategies, says ”Vital Strategies is proud to be an implementing partner of the Partnership for Healthy Cities, supporting the bold vision and exciting projects that are proving that rapid progress is possible everywhere in the world.”

How wonderfully inspiring. Pass me the tissues. However, before we get too emotional, let’s look briefly at what these august bodies are doing to combat the Number One cause of non-communicable disease – smoking.

However much WHO and BP spin the data, an independent assessment by Hoffman and colleagues reveals the WHO Framework Convention on Tobacco Control (FCTC), the bedrock on which control of smoking death and disease is founded, has had little impact. But there is too much financial, political and moral investment in doing anything other than keep digging into an ever-deepening hole of failure.


Tobacco harm reduction (THR) using safer nicotine products (SNP) is no silver bullet. But it has the potential to make significant progress if endorsed by the WHO which in turn would influence governments to act in support through proportionate and pragmatic legislation. But no.

Instead, the WHO remains implacably opposed to THR and will be working behind the scenes to persuade Parties to the FCTC to adopt a prohibitionist approach at the Conference of the Parties meeting next November. 

BP has given millions of dollars to the global war against nicotine and recently announced another $420 million mainly aimed at LMIC, but also to ‘combat’ e-cigarette use among US teenagers. The money will be more than just wasted.

Unheralded by the US authorities is that smoking among young people at under 2%, is the lowest prevalence rate in history. This leaves anti-smoking campaigners in a quandary. How to keep the dollars flowing? Answer – create the impression there is an ‘epidemic’ of teen vaping. Yet, according to the US Center for Disease Control, "epidemics" are diseases which are increasing in a population.

Teen vaping is a behaviour, not a disease, is only a minority behaviour among middle and high school students and has been falling in recent years. Most teen vapers are not daily users, nor do they go on to smoke, as the fall in teen smoking prevalence shows.

Throwing millions of dollars at this ‘problem’ is only going to hurt adult smokers who are looking to quit smoking. Politicians under pressure from parent activists have brought forward legislation to inhibit freedom of choice for those looking to switch. So money is not just wasted tackling an exaggerated issue but also serves to damage wider public health.

Second, more money will be wasted in LMIC with quick fix ‘solutions’ like graphic warnings, useless mass media campaigns, unenforceable laws and the like. Much better to spend money on stop smoking services in LMIC, marshalling all the possibilities including talk therapies, NRT and SNP. Oh hang on, BP won’t fund services that might actually make a difference. No quick wins to be had.

So what about Bloomberg-funded Vital Strategies? The CEO used to head up the virulently anti-THR International Union of Tuberculosis and Lung Disease (aka The Union). Vital Strategies have weaponised the media in the war against THR. They have directly sponsored anti-THR articles in mainstream media in the UK. Vital Strategies or its grantees have also provided funding to organised teams of investigative journalists, whose output has focused on the role of tobacco companies in the production of safer nicotine products and on discrediting THR as a viable approach to smoking cessation. The resulting articles are then pitched to and published in mainstream press in the UK, US and Europe, sometimes in coordinated campaigns across different countries. Views from those favourable to THR are not sought to provide balance to the reporting.  

And if anybody needed proof that opposition to THR was all about fighting the tobacco industry rather than the fight to reduce death and disease from smoking, then here we go.

You may not have heard of the Global Health Advocacy Incubator (GHAI). They appear to do all manner of good works and have a commendable set of working principles including:

 “We believe advocating for evidence-based policies is a means to achieve positive public health outcomes.

We consider health a fundamental human right, and we must take action to promote and protect it.

We believe policy change must be locally led and sustained. Our role is to enhance the ability of advocates to create the change they envision.

We respect the dignity, cultural context, capabilities and perspectives of the people in the countries where we work.”

The GHAI works mainly in LMIC, but specifically in the USA, their overdose prevention initiative “Advocates to ensure that evidence-based treatment and harm reduction services that help save lives from drug overdose are within reach. By advancing federal policies that address the disparities, inequities, and stigma in the addiction treatment system, we can make a difference in the lives of people across the U.S. and prevent needless overdose deaths.”

So far so good. And then you check out who heads this worthy outfit - none other than Matt Myers, head of the Campaign for Tobacco Free Kids. Buoyed up by Bloomberg money, this organisation is dedicated to denying the value of harm reduction in reducing death and disease from smoking, ignores the fundamental right of smokers to take control of their own health, actively campaigns against all the independent scientific evidence supporting the use of SNP and attacks those who do as industry stooges. So much for achieving positive public health outcomes.

It is very hard for those dedicated to the principles of THR – be they doctors, public health officials, academics, or consumer activists to take on the financial and political might of these organisations who peddle their damaging misinformation with impunity.

As the French medieval poet and early feminist Christine de Pizan wrote “Those who plead their cause in the absence of an opponent can invent to their heart's content, can pontificate without taking into account the opposite point of view and keep the best arguments for themselves, for aggressors are always quick to attack those who have no means of defence.”