The WHO Report on ENDS/ENNDS

It’s been rather busy outside of my vaper-sphere recently which has unfortunately led to a lot of things slipping, including this post. Many of you are aware that the World Health Organisation recently released all the documents for the upcoming tax-payer funded shenanigans to be held in India for Conference Of Parties #7 (COP7). There’s a number of documents that are of interest, some of which I’ll write about here but the main interest at the moment is the originally named document FCTC/COP/7/11 ‘Electronic Nicotine Delivery Systems and Electronic Non-Nicotine Delivery Systems (ENDS/ENNDS)’

When this document became public, there were a few that claimed the WHO had become more ‘supportive’ towards vapour products. The answer to that is…. not really. The WHO see vapour products (I flat refuse to call them ENDS or ENNDS – that’s tobacco control speak) as part of the overall ‘Endgame‘ to the “tobacco epidemic” – which, if you’ll remember from Chan’s opening statement at COP6 is more important than Ebola (emphasis mine):

Well we know how that all turned out don’t we? The WHO took substantially longer to combat Ebola than is strictly necessary because the FCTC COP6 was “too important”. Moving on to COP7:

The thing is, from the decision document on vapour products taken from COP6:

The WHO were, back in 2014, inclined to ‘suggest’ (which coming from the FCTC is tantamount to an order) any or all of the following “legislative options”:

• Impede “ENDS” promotion to and uptake by non-smokers, pregnant women and youth
• minimise potential health risks to ENDS users and non-users
• prohibit unproven health claims from being made about ENDS
• protect existing tobacco control efforts from commercial and other vested interests of the tobacco industry

Wait, isn’t that exactly what the TPD is doing?

A large proportion of the ‘decision’ from COP6 is already in the Tobacco Products Directive, which as regular readers will know was passed at EU level early 2014. Finally there is this nugget from COP6:

So, the FCTC “invites parties” to consider prohibiting vapour products, or if they can’t/won’t do that then regulate them as tobacco products, medicinal or consumer products. Considering that tobacco and medicinal products have the highest level of control and regulatory barriers, guess which way most Governments were likely to go?

From the time of COP6, much has changed in the legislative and scientific landscapes. 2015 saw the release of the PHE Evidence Update and earlier this year we saw the Royal College of Physicians report. Did they have any impact on the WHO FCTC? Well no, not really.

As you would expect, the section on health risks of “ENDS/ENNDS” relies heavily on possibly the most outlandish junk science:

Not to mention thin, baseless claims of “future problems”:

Well, we’ve already seen some of the “science” that would lead the WHO to make such outlandish claims haven’t we (here and here). While the use of vapour products isn’t without risk, a balance does need to be struck between the “risks posed by smoking” against the “risks posed by vaping” – or should we just mention the Parachute Conundrum?

They are, of course, highly concerned about the promotion of “ENDS” and claim that the “free for all” marketing and promotional material (which varies by manufacturer – who knew?) is:

One of the many, not so subtle statements that are saying “these things are going against all our previous tobacco control efforts” – which we all know is what they really want. Control. An elected UN agency has no business trying to control our lives. Think they may have overlooked their own definition of “tobacco control” as per their own document:

Do read Carl Phillips’s recent publication on tobacco harm reduction should a more detailed explanation be needed.

As for the regulatory options that are being proposed, consider it ling-ch’ih:

Objective: Prevent the initiation of ENDS/ENNDS by non-smokers and youth with special attention to vulnerable groups:

The final point of that objective is an interesting admission – “combat illicit trade” – suggesting that the WHO recognises that their draconian measures may kickstart a black market for vapour products. Perhaps they’ve learned from their dealings with the tobacco industry? We’ve seen how the ridiculously high prices in Australia have led to a surge in the illicit market with large quantities of the product being seized outside of “official channels” – which begs the question, how much is still getting through?

Objective: minimise, as far as possible, potential health risks to users and protect non-users from exposure to their emissions:

Noble goals. Of course, testing the liquids should be bloody mandatory by now regardless of the regulatory landscape. The industry has proven that it can, and will react to concerns. However the big issue with testing is that there is currently no testing regimen to adhere to. The BSI PAS went a long way towards that goal, but that was only in reaction to the limited amount of wiggle room available within the TPD. Imagine what a free-rein would see in that area! Of course, the ability to monitor and report adverse effects is possibly one of three sensible options under this objective, the second being the ability to remove products that are not safe to use with the third being the electrical and fire safety standards.

So, to “protect” non-users, public space bans (which is wherever smoking is banned), health warnings (no doubt plain packs would follow that) and limit the nicotine strengths. Remember, this is exactly what is happening via the TPD and the various implementations. No consideration of the unintended consequences to users.

Then there’s the final objective recommendations.

Objective: protect tobacco control activities from all commercial and other vested interests, including interests of the tobacco industry.

Gosh, these folks really do fear the tobacco industry don’t they? Perhaps a reminder of one of their founding articles. Article 5.3:

Interestingly, the report highlights the need for _transparency _in dealings with the industry, but of course the actual COP will not be transparent. You’ll remember of course that the _press _and public were turfed out of COP6, which was hardly transparent at all.

The UN Framework Convention on Climate Change is far more transparent than the FCTC – getting observer status at FCTC requires a multitude of specific requirements that “align” with the goals of the FCTC – which rules me out then.

When talking about conflicts of interest, they aren’t just talking about financial conflicts, instead they mean anything that can potentially conflict with the goals of the FCTC – which in most cases rules out actual stakeholders such as NNA or ECITA, as both groups would conflict being entirely pro-vapour product, and mostly against a proportion of the draconian measures proposed by the FCTC.

Aside from the opening statement under the heading “Potential role of ENDS/ENNDS In Tobacco Control” there is very little in this “expert report” that is supportive of a product that, if left to innovate with light touch regulations stemming from strong standards, could very well do exactly what the FCTC want. But then, that’s a case of “not invented here”. The only thing the FCTC have contributed to this is the ridiculous terms “Electronic Nicotine Delivery Systems” and “Electronic Non-Nicotine Delivery Systems”.

Banning sale to minors is relatively uncontroversial (though I do disagree with that) and does have fairly widespread support, but to ban possession is very 1984. There’s no ban on possession of tobacco or alcohol by minors, so why impose such a ban on vapour products?

Bans on advertisements are just ridiculous. At least under the TRPR posters, billboards and leaflets are allowed but frankly, vapour products should be advertised far and wide. All that is needed is common sense.

Taxation to prevent youth buying them is bonkers. Taxation is the easiest method for Governments to generate a revenue stream on products that they can’t or won’t ban outright, but would rather people didn’t actually buy. In this context, the report states:

What they don’t realise is that higher e-cigarette prices are likely to lead to a stabilisation or even an increase in the sales of combustible tobacco. These people are insane.

The talk on flavours enticing kids is moot, considering that the vast majority of new users over the last two years cite flavours as one of the key reasons why vaping works for them. There is no such thing that flavours can only appeal to youth but not adults or vice versa. The very idea is simply ridiculous.

Indoor bans, as we saw with the attempt in Wales, is a ridiculous idea and is only really supported by people who just don’t like it. Even outdoor public space bans are a ridiculous idea, one that isn’t mentioned in the FCTC document but will no doubt be discussed. There is no evidence that the aerosol from a vapour product is harmful to bystanders and frankly, it’s not the business of the WHO to tell governments how to deal with it even if it did.

Bans, flavour choice reductions, bans on advertising, regulating places that can sell and taxation. Yes, these proposed regulatory options are indeed ling-ch’ih. This type of attitude towards a reduced risk product, which doesn’t just mean vapour products, but snus and other forms of smokeless tobacco, is where the real harms lie. It is this machine that not only propagates fear, but feeds on its own fears.

Tell me, isn’t the World Health Organisation supposed to be about health?

(image credit ra2studio/shutterstock.com)