This article is part of our special report Tobacco control: What’s next?.
In an interview with EURACTIV.com, Dr Vera Luiza da Costa, the head of secretariat of the WHO Framework Convention on Tobacco Control (FCTC), has criticised the tobacco industry, saying that with its push for electronic cigarettes the trade “just changed clothes while the content remains the same.”
FCTC is a United Nations tobacco control treaty which entered into force in 2005 and has been ratified by 181 countries across the world.
Speaking on the sidelines of the fourth International Conference on Tobacco Control in Bucharest, Dr Da Costa talked about the progress of the treaty’s implementation and highlighted the challenges that lie ahead.
Referring to electronic cigarettes and other novel tobacco products, Dr Da Costa said they only allowed the tobacco industry to change clothes. “It now has a new outfit but the content is zero again. The impact on adolescents is huge and on young people in general. See what is happening in the US,” she said.
She added that the tobacco industry just wants to improve its image and sit around the table as a partner. “But in reality, the tobacco industry objectives and the public health goals are irreconcilable.”
“They now say they want to leave the cigarettes market. This might be a good argument for the European developed countries but in fact, their promotion is even more aggressive in the developing world, in Asia, Africa and Latin America countries. So, it’s an empty argument.”
“The discussion about harm reduction and their argumentation is opportunistic as the scientific community is pretty much divided over the potential harm reduction these products could cause,” she warned.
She added that there was common scientific ground that young people who had never had access to nicotine products before should not start taking up electronic nicotine delivery systems.
“This is what we are seeing happening around the world.”
“How can you frame the discussion about harm reduction toward children, who are not exposed to any harm because they are not smokers? They promote a product that has the appeal of harm reduction but it ultimately harms children and adolescents and leads them to one of the drugs that causes the highest dependence worldwide, nicotine.”
She added that governments should prohibit or regulate any of these products that come to the markets.
Referring to the UK, she said it was making an attempt to use electronic cigarettes as a potential means to assist persistent smokers who have not been able to quit.
“But what is going to happen in the long-term is still to be seen. It’s a country that has a very good regulatory and monitoring framework and calculates the progress and eventually changes the process to it.”
“Comparing the UK with a developing country, which has not implemented the provisions of the treaty, it has a low rate of smokers and then you bring electronic cigarettes: To reduce what harm? They are going to bring additional harm to the country in this case.”
She said the if countries don’t want to ban such products then they should at least regulate them based on the precautionary principle “to avoid misleading disclaimers and the product promotion to children.”
“If you allow these products to bypass the tobacco rules, then they will be allowed in public places and this will help re-normalise and re-socialise the tobacco use. This is a big consequence for public health,” she warned.
The treaty implementation
The treaty is composed of demand reduction measures, such as taxes and pictorial warnings, and supply reduction measures.
She said Article 8 on smoking bans in enclosed public places is the most widely implemented. On the contrary, countries are lagging behind when it comes to Article 17, which is related to alternative livelihoods for tobacco growing.
“As you move on with the demand reduction measures, the demand decreases and it’s expected that the supply will decrease too in the medium-term. The demand decreases so you don’t need to produce as much,” Dr Da Costa said.
According to the WHO official, the tobacco industry should be liable for the damage it causes. “There are a number of governments which file lawsuits against the tobacco industry and ask for compensation for the healthcare costs the tobacco industry is responsible for,” she said.
She added that there were also governments, which have adopted a more indirect approach, earmarking part of the tobacco taxes to public health initiatives and tobacco control.
“The tobacco companies should pay for the costs they oblige governments to take,” she said.
Taxation decreases consumption
She said there were numerous examples across the world where higher taxation has resulted in reduced consumption of tobacco products.
According to Dr Da Costa, taxation is one of the provisions of the treaty which has immediate effects because “once the costs increase, there is an automatic reduction in consumption, especially among young people and lower economic classes.”
Referring to the tobacco industry argument that taxation leads to an increase of illicit trade, she said they were only using this argument to “kill” taxation and urged countries across the world to continue increasing tobacco taxation.
“In Brazil, the government has already reduced taxation, reducing the revenues as well, but the illicit tobacco trade has not decreased. Then they increased taxation, which immediately decreased consumption, increased revenues but the illicit trade continued the same,” she said.
She also cited the example of Norway, where taxation decreased consumption without increasing illicit tobacco trade.
“The illicit tobacco trade has other aspects involved. It’s tightly linked to corruption, criminality, border controls etc.”
“With every provision of this treaty, the tobacco industry comes up with the illicit tobacco trade argument. And at the end of the day, the tobacco industry is responsible for the illicit trade itself. It uses it to open up to new markets, to test new products in markets where they have no official presence,” she said.