The word ‘framework’ indicates that ultimately it is down to the signatories as to how they interpret or add flesh to a convention. Technically such conventions are ‘legally binding’, but this does not mean that any signatory is going to be hauled into court for not following the letter or the spirit of the agreement. If anything, it is more of a moral obligation. This also applies to the international agreements over illegal drugs. Regarding cannabis, Canada, Uruguay, Portugal and some other countries are technically operating outside the Single Convention on Narcotic Drugs. International drug agency officials might voice disapproval, but beyond that – hey, knock yourself out.

Tobacco control is generally regarded as a technical, scientific and bureaucratic task to be handled by low-middle level officials and traditionally has not been a top-level political concern. For a politician to be talking about death and disease from smoking does not make for a good news story, especially in countries which have a big stake in the domestic tobacco industry and/or rely heavily on tobacco taxes.

It is these same middling bureaucrats who attend the FCTC Conference of the Parties (COP), regarded by most delegates as a foreign travel perk. The British PM, Rishi Sunak, faced heavy criticism for saying he was too busy to attend the recent Framework Convention meeting on Climate Change. He was forced to relent and put in a token appearance. It’s hard to imagine a national leader being humbled for not attending the FCTC COP.

So the health problems caused by smoking appear way down the domestic political agenda. This has meant that influence over international tobacco control policy has mainly been ceded to the WHO and the FCTC Secretariat. Those FCTC signatories from low- or middle-income countries (LMIC) will generally toe the WHO line both because the WHO is a trusted source of public health information and because individual countries can just impose boilerplate legislation without having to think too much about it. However the advent of tobacco harm reduction (THR) using safer nicotine products (SNP) has added a whole new dimension to the politics of global tobacco control.

Firstly, THR has become a political issue. Politicians are guaranteed to garner the media attention they crave by essentially lying about the dangers of vaping. They play the ‘kiddie card’ with evidence-free statements about the teen vaping ‘epidemic’, laying the blame squarely at the feet of Big Tobacco.

Secondly, with their established grip on international tobacco control deliberations, the anti-THR zealots in Geneva now have free reign to apply all their industry paranoia in a whole new field. Much of what goes on happens behind closed doors, with no publicly available agendas or minutes. For example, the WHO has gradually increased its presence at the secret meetings of the Global Tobacco Regulators Forum. The WHO also announced a ‘Global Consultation on Novel and Emerging Nicotine and Tobacco Products'. This took place in Geneva in June and was no such thing – just a group of hand-picked countries gathered in a room. Meetings of this kind are most likely attempts to engineer a consensus view on more prohibitionist regulation of SNP in the run-up to the scheduled debate at the next COP meeting in November.

As I say, this hijacking of the international tobacco control agenda by the WHO has happened through political apathy. But because of the manufactured controversy around THR, the WHO now has the active support of politicians from many countries who can use the issue to demonstrate their eagerness for headline grabbing ‘tough action’.

In the light of THR and the implications for improved public health, there have been calls, most notably from former WHO Director Professor Robert Beaglehole, for FCTC Parties to ‘take back control’ of the FCTC and inject some much-needed proportionality and pragmatism into the convention.

Recently the UK government responded to a parliamentary question about the UK’s position at COP regarding SNP as follows:

“The Government has regularly set out our position on vaping at the Conference of the Parties of the Framework Convention on Tobacco Control and will do so at the next conference in November 2023. The delegation will not agree to any decisions which would impact on our ability to make regulated vapes available for adult smokers who wish to quit smoking.”

This is obviously a good stance to take on THR and underlines that tobacco control is a domestic issue. But there is no evidence that politicians have any appetite for getting stuck in the mire of convention re-negotiation. Even if they did, you can bet that the WHO and the FCTC Secretariat would do everything in their power to offer all the passive resistance they could muster.

The UK, Sweden, Norway, Japan and New Zealand and now, importantly, the Philippines, have shown that each country holds in its political grasp the destiny of those nicotine users who want to switch away from smoking. It is to the eternal shame of many nations that their politicians are prepared to play fast and loose with public health in the service of cheap headlines - which do nothing to reduce the toll of smoking.


Want to know more? Read the GSTHR's The FCTC and the COP: an explainer, available in: English, Arabic, Chinese, French, German, Hindi, Indonesian, Japanese, Polish, Portuguese, Russian, Spanish and Swahili.