The Foundation for a Smoke-Free World (FSFW) welcomes the release of the 2018 Global Progress Report on Implementation of the WHO Framework Convention on Tobacco Control (FCTC). While we remain optimistic about the progress of the work undertaken to slow the demand for combustibles, the FCTC Secretariat’s approach and direction, as it relates to smoking cessation and harm-reduction products (HRPs), requires comprehensive review.

Progress on smoking cessation has stalled for two decades. We seek to inject greater innovation and urgency into developing affordable and far more effective solutions to help smokers durably and successfully quit.

There is overwhelming evidence that HRPs are game changers for smokers trying to quit. However, the WHO FCTC report puts these products in the same category as water pipes (sheeshas), suggests that HRPs need to be “tackled,” and that they are “considered the most serious barrier to progress.” This is all misleading. HRPs may well contribute to progress towards the end of smoking. Smoking rates have declined in many countries where smokers embrace HRPs, such as the UK, Japan, and Sweden. The fact that smoking rates have gone down since people started using HRPs proves that these products are important tools to end the smoking of combustibles, as reported in “No Fire, No Smoke, Global State of Tobacco Harm Reduction.” This independent report aims to build further awareness of harm reduction and the potential benefit it can bring. Insights from this report demand action.

We agree that there are shortcomings in the tactics that have been used to end smoking, as identified in the report. For example, the report references “the lack of human and financial resources” and that “technical assistance is still very much needed in the fields of taxation, policy development, research, and national cessation programmes.” FSFW has available resources that can be dedicated to a collaboration with the WHO to address several of these issues.

Additionally, we agree that smokers, policy makers, and stakeholders need reliable and objective data from research institutions and universities to fill the gaps in knowledge. To address these gaps, FSFW is investing in institutional building that includes funding Centers of Excellence to help next-generation leaders in research in low- and middle-income countries build their capacity for innovative research that will accelerate the end of smoking. One of our earliest analyses showed that about 90% of all research funding for tobacco control and smoking cessation occurs in countries that are home to only 6% to 7% of the world’s smokers! Together, we need to rectify this.

The smoking epidemic is a global health issue that demands a global, comprehensive, and collaborative approach. This means embracing harm reduction as a tobacco control strategy and as a powerful tool to help smokers quit, especially those living in low- and middle-income countries. We are ready to partner with those who share our goals to accelerate ongoing progress and to put an end to smoking worldwide.

Ehsan Latif