The World Health Organization warned against the health risks of nicotine and related products in a position paper on tobacco control and harm reduction issued on Wednesday.
Published ahead of the Conference of the Parties of the Framework Convention on Tobacco Control (FCTC) next week, the position paper draws attention to the role of the tobacco and nicotine companies.
According to the paper, the companies are misappropriating the public health concept of harm reduction while mass marketing harmful products like e-cigarettes and nicotine pouches (nicotine-containing products that are consumed orally) to the public at large. All tobacco, nicotine and related products pose health risks, including risk of addiction, WHO warns.
In particularly, the high and rising levels of e-cigarette use among young people is alarming. Recent WHO trends data shows that globally over 15 million children aged 13–15 now use e-cigarettes (vaping) and that children aged 13–15 are, on average, nine times more likely than adults to use e-cigarettes. WHO also recognizes that quitting tobacco is difficult.
“Since the FCTC took effect twenty years ago, tobacco use has declined by one third globally, despite the efforts of the tobacco industry to undermine it,” WHO Director-General Dr Tedros said at a press conference. “Many of the 1.2 billion tobacco users worldwide want to quit and they deserve support that is safe and effective.”
However, the use of nicotine products such as e-cigarettes and nicotine pouches has expanded rapidly due to aggressive marketing, with bright packaging, sweet flavours, social media influencers, and false claims of ‘harm reduction’.
“Let’s be clear: the companies that make these products are not motivated by harm reduction or health. They are motivated by one thing and one thing only: generating profit for their shareholders.” WHO recommends that all countries regulate nicotine pouches, e-cigarettes, heated tobacco products and smokeless tobacco at least as strongly as they regulate conventional tobacco products.
Several countries have prohibited these products. The WHO recommends that those that have not should use strict controls on flavours, packaging, marketing and sales, protections against industry interference, and enforcement of age restrictions.
The tobacco industry opposes more regulation and claims that it implies a shift from a science-based approach to tobacco control toward outright prohibition. Instead of encouraging safer alternatives which could save lives, according to the industry, policymakers are reaching for bans, excessive taxation, and product restrictions.
Alarming trend in the EU
In another recent report, WHO/Europe showed that the EU has achieved important policy progress – yet tobacco continues to claim more than half a million lives every year. Of these, almost 80,000 die from exposure to second-hand smoke. It remains the leading cause of preventable death in the EU, accounting for 17% of all premature deaths from noncommunicable diseases.
The WHO European Region is already the world’s leader in e-cigarette use among adolescents (13–15 years old), and the trend is on the rise and very visible across the EU. While adult smoking rates are declining, use of nicotine products among young people is rising sharply.
“After decades of policy action across the 27 EU Member States, the overall burden of tobacco in Europe remains immense, with large variations between countries,” commented Dr Hans Henri P. Kluge, WHO Regional Director for Europe.
The implementation of evidence-based tobacco control measures across EU member states remains uneven, according to WHO/Europe. All EU countries monitor tobacco use and have large pictorial health warnings, but only 8 have achieved full smoke-free environments and only 4 countries have comprehensive advertising, promotion and sponsorship bans.
In 14 EU countries, cigarettes have actually become more affordable since 2014, eroding progress. As of 2024, only 6 of 27 EU countries had banned e-cigarette flavours, and approximately half of the EU Members States apply partial restrictions on e-cigarette advertising.
In Belgium, the situation is somewhat better, according to a recent analysis of the Global Tobacco Industry Interference Index by the Belgian Health Institute, Sciensano. Around 18% of people over the age of 15 smoke and 8% of deaths are tobacco-related. While Belgium’s ranking is above average, progress remains slow in implementing stricter regulations and increasing transparency.
“A tobacco-free Europe means much more than just a policy goal reached. It means a future where children grow up free from addiction, where the air is cleaner, and where health and well-being are shared values for all.”
