My friend Ethan Nadelmann once told of a conversation he had with an officer from the US Drug Enforcement Administration. Ethan asked him if there was anything they could agree upon, any common ground across which a bridge could be built. The officer replied that the wall between their views was just too high for him to want to climb over and engage in meaningful dialogue.
On the strength of the latest example hot from the desk of the WHO, I fear that is where we are with this agency too. It almost seems pointless to continue berating the WHO over its intransigent opposition to safer nicotine products (SNP). At one level it is a bit like continually criticising the DEA for not supporting drug law reform. Except the DEA is a law enforcement agency; they have a remit to enforce the drug laws whatever they might be. They don’t have a mission to be concerned about the welfare of drug users – and they aren’t. But the WHO is supposed to be an agency with a ‘health for all’ remit, so the deliberate undermining of efforts to increase the availability of SNP is something that should be highlighted at every turn.
Despite being early to introduce smoking bans and ratify the FCTC, Turkey had planned to allow the sale and production of SNP. However, on 17th October, the Turkish Minister of Finance announced these plans had been withdrawn prompting the WHO to hold a press conference in Ankara applauding the decision. The press release was full of the usual WHO rhetoric about the alleged threat to public health posed by SNP and how it was all an industry plot.
Professor Hilal Özcebe, Public Health Specialist at Hacettepe University, was wheeled out to add weight to wrong information
“The tobacco industry states that electronic products have fewer negative effects on public health but this is a totally false argument.” She explained that “electronic devices have the same level of nicotine as widely used products [such as cigarettes], causing similar vascular disorders and cardiovascular diseases”.
The WHO laud Turkey as a shining example of getting serious about tobacco control except that 30% of the country still smoke (2016 WHO figures) and Turkey is awash with illicit tobacco, estimated in 2013 at 16 billion cigarettes a year directly as a result of rising excise duty on cigarettes. But instead of doing all it can to help smokers away from cigarettes whatever their provenance, the WHO consistently does the exact opposite
One comment I’ve seen suggests that the WHO attitude to SNP is less a drive to protect public health and more a drive to protect its own bureaucratic status quo in the face of disruptive technologies and SNP especially in low and middle-income countries where it does wield significant influence similar to other international bodies such as FIFA and the International Olympic Committee who have hopped from one scandal to the next. I can’t think of another global health crisis where positive results can be delivered outside of the control of national and international health bureaucracies and Big Pharma.
The Russians built a wall to keep people in; Donald Trump wants to build a wall to keep people out. The WHO appear to be building a wall between a self-evident public health truth and the public itself.
Cigarette production in the UK is now at the fag end of history. The only remaining production plant in County Antrim, Northern Ireland owned by JTI has just closed. The company bought out the locally-based firm of Gallahers in 2007 and closed the Ballymena plant ten years later. In the 1850s, Thomas Gallaher from County Londonderry began selling hand-rolled tobacco from a pushcart - he grew the business so that by 1896, he owned the largest tobacco factory in the world. The company had global reach, but main UK brands were Benson & Hedges, Silk Cut and Senior Service. At £7.5 bn, the takeover of Gallahers by JTI was the biggest acquisition in Japanese corporate history. Production in England ended in May this year with the closure of Imperial Tobacco’s factory in Nottingham.
The decline in UK smoking prevalence has been dramatic. In the 1940s, nearly two-thirds of UK men were smokers: by 2016, the overall figure was down to under 16%. The British government banned tobacco advertising on television as early as 1965. Greater public awareness of the health risks, high costs and smoking bans in pubs, restaurants, shops and other workplaces have stubbed out the cigarette industry in the UK, while the growth in sales of SNP continue to grow.
Gallaher had a significant investment in Indonesia with the Djarum brands and ownership of Wsmilak, the sixth largest tobacco company in the country. Smoking shows no signs of reducing there with a reported male smoking prevalence in excess of 67% and possibly on track to having the highest smoking rates in the world.
So knowing they have a huge smoking problem that’s out of control, the government’s response is to ban all sales and imports of SNP. It almost seems like a pissing contest among repressive regimes (step forward Thailand and the Philippines) to see who can make the toughest noises about SNP while their people are dying like flies – and with the WHO cheering from the bleachers. #faceinthesoup.
Forge that gripping Scandinavian crime thriller, watch our esteemed Prof Stimson in action – and no, I’m not going to spoil the ending – or the ENDing!
And finally, having vaguely got your attention, I am launching a new campaign called CANUTE – Campaign AgaiNst Ureadable TExt – a mission to turn back the tide of report production which favours white typeface on a pale, pastel background. We are supposed to be living in a time of empowerment inclusion and engagement which is somewhat undermined if you are excluded by dint of poor eyesight. And this goes for websites as well as print. So the next time you commission report production from Hip Cool Media Inc – remember, it’s naming and shaming from now on!