WHO puts its case against e-cigarettes: time to round up the usual suspects

It’s hard to deny that in principle, and very often in practice, the World Health Organization (WHO) has a rightful leading place among the Good Guys. In face of something as threatening as Covid-19, for example, who would you rather trust – your government (wherever in the world you may be) or the WHO?

However, as a 73-year-old global institution with an annual budget approaching $8bn, derived mostly from voluntary contributions from both its member states and private donors, it can hardly be expected to be at all times uncontroversial. When it brings its massive international influence to bear on e-cigarettes it never is.

When it publishes a document as weighty, and as dogmatic, as its eighth report on “the global tobacco epidemic”, presenting what it calls “new data on electronic nicotine delivery systems, such as ‘e-cigarettes’ ”, it inevitably makes headlines. And just as inevitably the usual suspects line up in their usual places on either side of the argument.

The Spectator, august outlet of Britain’s right-wing establishment (among its former editors is the UK’s current prime minister), runs with “The WHO’s bizarre war on e-cigarettes”. It would have been news had the writer, Christopher Snowdon, member of the libertarian Institute of Economic Affairs and noted e-cig enthusiast, taken any other line.

Just as it would had the multi-billionaire Michael Bloomberg, major WHO donor and backer of what might be termed the War on Vapes, been spotted taking a sly puff on a Juul.


‘A new generation of smokers’


One sample headline from Bloomberg’s corner of the ring (this one’s from the Dubai-based Khaleej Times, but it could be from almost anywhere in the world): “E-cigarettes spawning a new generation of smokers”.

At first sight, that looks like another example of that dreary – often deliberate and tendentious – failure to distinguish between smoke and vapour. But no. It turns out on reading beyond the head to be a case of that other aging chestnut, the “gateway effect”.

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    “The WHO is concerned,” the article says, “that children who use these products are up to three times more likely to use tobacco products in the future and there are fears that e-cigarettes would create a new generation of smokers.”

    Therein lies the nub of Bloomberg’s opposition and it would be a good argument if it were supported by facts rather than just assertions. And that, fundamentally, is the problem: too many blanket assertions, too little corroborating evidence. On both sides of the question.

    Let’s look at a few of the WHO’s salient points, as conveniently picked out by the Khaleej Times:

    • Nicotine is the primary agent in both regular cigarettes and e-cigarettes, and it is highly addictive.”
      Primary agent of addiction, yes, but not of the truly damaging health effects, which come predominantly from tar and other constituents of smoke.
    • “It causes you to crave a smoke and suffer withdrawal symptoms if you ignore the craving.”
      Not really. If you crave nicotine and have an e-cig handy, you don’t have to smoke to satisfy the desire. That’s rather the point.
    • “Though marketed as safer way to smoke, e-cigarettes are equally harmful.”
      This is where the WHO and many others really let fly with the unsupported assertions. All the best evidence so far suggests it’s simply not true. So far.


    ‘Riddled with bias’


    In the other corner, step forward Michael Landl, director of the World Vapers’ Alliance (WVA), with a few assertions of his own: “Besides being riddled with biased anti-vaping scaremongering and false claims, the entire direction of travel set out in the latest WHO report is nonsensical. Rather than focus on the all important goal of beating smoking, the WHO is turning its guns on vaping, the most powerful smoking cessation tool on the planet.

    “They clearly find it more important to fall into line with the narrow-minded ‘quit or die’ approach trumpeted by the WHO’s billionaire sponsors, like Mike Bloomberg. The reality is that if the world follows the WHO’s lead, fewer smokers will quit and more will die as a consequence.”

    It would have been surprising, too, if the director of the WVA had taken any other line. And however forcefully the arguments are put on either side it’s hard to imagine anyone being seriously swayed in either direction until a lot more real-world evidence is available. 

    For now there’s a whole lot more rhetoric than science in the air.  Whichever way you look at it.

    – Aidan Semmens ECigIntelligence staff

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    Aidan Semmens