The eighth session of the Conference of the Parties (COP8) to the World Health Organization (WHO) Framework Convention for Tobacco Control (FCTC) opened on Monday, October 1, 2018, in Geneva, Switzerland. This weeklong series of discussions will focus on global progress that has been made in the fight against tobacco. The FCTC, a treaty that has 168 signatories, entered into force in 2005 after it had been acceded to, ratified, accepted, or approved by 40 Member States.

Participants of the COP8, including delegates from 181 Member States, are also expected to advocate for more widespread implementation of tobacco control measures, including plain packaging, terrifyingly gruesome images on tobacco product packages, higher taxes on tobacco products, advertising bans, and smoking bans in public spaces. Delegates will also consider extending tobacco control policies to cover tobacco harm reduction products (THRPs) such as e-cigarettes and snus – even though “harm reduction” is actually part of the FCTC’s official definition of “tobacco control,” as per its Article 1(d).

I am cautiously pessimistic about COP8, but I am also excited about this event for several reasons. One of them is the publication on October 2, 2018, of No Fire, No Smoke: The Global State of Tobacco Harm Reduction (GSTHR) 2018 ⁱ, a well-researched paper on the current state and future potential of tobacco harm reduction. The GSTHR report was authored by the UK-based nonprofit, Knowledge Action Change (K.A.C.). I believe that history will eventually see that acknowledgement of tobacco harm reduction strategies is an important step on the path toward “an end to the age of smoking.” I’m hopeful about this report, which covers the public health community’s response to “harm reduction.” The GSTHR report reviews the continuing global epidemic of cigarette smoking, the current evidence supporting safer nicotine products, consumer needs and health outcomes, as well as regulatory and control issues.

The International Network of Nicotine Consumer Organisations (INNCO), which represents 36 member organizations in 33 countries, will also be present at the COP8. The organization, which advocates for the interests of 50 million users of THRPs, is a strong proponent for their use. INNCO’s Secretariat and Board, along with the leaders of its growing member organizations, will no doubt be presenting evidence on tobacco harm reduction, especially following its recent public letter to the WHO. In that correspondence, INNCO appealed to the agency, asking them to reject prohibition of THRPs and acknowledge risk-proportionate regulation of tobacco and nicotine products that do not involve combustion, as part of an effective harm reduction strategy.

THRPs include “vaporizers” (now the preferred term for e-cigarettes) and/or “snus,” a smokeless tobacco product that is also considerably less harmful than cigarettes. Snus originated in Sweden, the only country in the EU that enjoys an exemption from the prohibition of the use and sale of snus, pursuant to Article 151 of the Act of Accession of Austria, Finland and Sweden. Sweden now has the lowest smoking and smoking-related disease rates in Europe.

Since COP7, more and more countries have embraced tobacco harm reduction as part of their national tobacco control strategies, while others have outright banned THRPs. In time, we will see which of these strategies has been most successful in reducing smoking rates and tobacco-related diseases. Unfortunately, too much time. Let us hope that COP9 will adopt a more inclusive and rational approach to harm reduction.

ⁱ The conception, design, analysis, and writing of No Fire, No Smoke: The Global State of Tobacco Harm Reduction 2018 was undertaken by Knowledge Action Change (K.A.C.), a private sector public health agency, and supported solely by a grant from the Foundation for a Smoke-Free World. The Foundation played no part in determining the content, analysis, or conclusions in the report and provided input only at the initial concept stage.