Wednesday, November 24, 2010

WHO FCTC May Kill Millions of Smokers

It is shocking to read that the Parties to the World Health Organization Framework Convention on Tobacco Control (WHO FCTC) want to prevent the use of two of the most effective methods for achieving smoking abstinence. (

Smoking prevalence rates have stagnated. The United States Centers for Disease Control and Prevention as stated: ““To further reduce disease and death from cigarette smoking, declines in cigarette smoking among adults must accelerate.” (CDC MMWR Vol. 59 / No. 35

When used as directed to wean down and off nicotine, medicinal nicotine products have a success rate of 7% at 6 months, 5% at one year, and only 2% at 20 months. (Moore D, et al. Effectiveness and safety of nicotine replacement therapy assisted reduction to stop smoking: systematic review and meta-analysis. BMJ 338:b1024 2009

The main reason medicinal nicotine products are so ineffective is that they require sustained nicotine abstinence. As soon as treatment ends, relapse begins. Dr. Brad Rodu of the University of Louisville states, ““Given that the outcome measure for all smoking cessation trials in the U.S. is complete abstinence, it is no wonder that most cessation methods are deemed failures. For successful tobacco regulation, the FDA must break the public health community’s addiction to abstinence promotion.“ (

Let’s compare the success rate of medicinal nicotine to methods that do not require nicotine abstinence.

Dr. Karl Erik Lund compared quit rates, defined as the percentage of ever smokers who are now former smokers, among snus users and never users of snus in seven previously published Norwegian surveys. The results were published in Addiction magazine. (

Lund Survey No. Quit Rate - Snus Users (%) Quit Rate - Never Snus Users (%)

It is important to note that not all smokeless tobacco products are alike. Swedish snus is formulated to reduce cancer-causing nitrosamines. Studies show that the health risks associated with Swedish snus use are significantly lower than the health risks of continued smoking. An assessment by Gartner, et al published in Lancet found “There was little difference in health-adjusted life expectancy between smokers who quit all tobacco and smokers who switch to snus (difference of 0.1-0.3 years for men and 0.1-0.4 years for women). For net harm to occur, 14-25 ex-smokers would have to start using snus to offset the health gain from every smoker who switched to snus rather than continuing to smoke. Likewise, 14-25 people who have never smoked would need to start using snus to offset the health gain from every new tobacco user who used snus rather than smoking.” (

As for electronic cigarettes, most of the world-wide panic has been generated by a very misleading press conference held by the U.S. Food and Drug Administration regarding their testing of 18 electronic cigarette cartridges made by the two companies engaged in a lawsuit against the agency (a strong signal of bias).

The FDA failed to point out that the highest quantity of “carcinogens” detected in a cartridge is equal to the quantity in an FDA-approved nicotine patch (8 nanograms). The quantity of diethylene glycol detected was so miniscule that a 150 pound person would need to ingest the contents of 100,000 cartridges in a single day to be poisoned. So why all the panic? Electronic cigarettes are about as dangerous as FDA-approved nicotine products, which makes them several orders of magnitude safer than smoking.

Critics keep claiming that there is no proof that electronic cigarettes help people to stop smoking. If by “stop smoking” they mean “achieve total abstinence from nicotine” then the critics are correct. However, if what they mean by “stop smoking” is to stop inhaling smoke and to enjoy all the resulting health benefits, then the critics are wrong. Surveys of electronic cigarette users consistently show that a large majority of users are able to substitute the electronic cigarette for all of their smoked cigarettes.

Survey ## SubjectsQuit Rate
Heavner K, et al. Electronic cigarettes (e-cigarettes) as potential tobacco harm reduction products: Results of an online survey of ecigarette users, Tobacco Harm Reduction Yearbook 2010.30379%
Etter JF. Electronic cigarettes: a survey of users. BMC Public Health 2010, 10:231.8163%
The Consumer Advocates for Smoke-Free Alternatives Association, online survey of e-cigarette users.221780%

Here is a summary of the success rates for the three methods of achieving smoking abstinence:

MethodSuccess Rates
NRTBest Case: 10-15%
As directed: 2-7%
Swedish Snus55-90%
Electronic Cigarettes63-80%

If the WHO FCTC succeeds in pushing electronic cigarettes and smokeless products such as Swedish snus off the market, they will have succeeded in making a significant contribution to the death of millions of smokers who could have quit smoking by switching to a safer source of nicotine.


  1. Nice article Elaine, thanks.

    The scope of the FCTC or definitions of tobacco products were not changed by signing parties but nicotine and paraphernalia is being taken into tobacco control by the WHO anyway. Bodies advising destruction of the harm reduction market include US groups such as Tobacco Free Kids. This is now global tobacco control industry policy even where governments haven't signed up to the FCTC.

  2. I recently decided to quit, and I am familiar with and own several ecigs. I use them at work, because they are allowed at my job.

    I had 2 packs of cigarettes left, and decided that when they were gone, I would quit.

    I had ZERO problem quitting and have only marginally increased my ecig usage.

    I attribute this 100% to my ecig. I knew that when I wanted my nicotine fix, I could grab my ecig. I didn't NEED a cigarette.

    THIS is what they fear. They fear a populace empowered to break themselves of the addiction cycle.

  3. Nicely summarised, EK. One only has to wonder that the WHO and others continue to rally against Snus and e-cigarettes against overwhelming evidence and logic - surely the reason for this illogical anti-nicotine campaign must be greed and corruption.

  4. It is more and more clear each day that the governing powers truly dont want us quit smoking. Plain and simple.

    They want to make it appear that they only have our health at mind but come on, really? Really?

    I think there is very little to do with our good heath that is inspiring the Governing parties.

  5. Greed and corruption are certainly at the center for these decisions to ban the use of products that have been proven effective. I quit burning tobacco in March and I know that e-cigarettes work. The refusal of health organizations to do any honest research on e-cigarettes and publish their findings that would prove their effectiveness and harm reduction, is paramount to murder. Shame on the WHO, the FDA and the Pharmacuetical companies behind the mis-information. How dare you kill so many people and say it is in the interest of public health.

  6. Except that -- the only thing that was actually decided in November was to get the FCTC Secretariat and the WHO Tobacco-Free Initiative to prepare a "comprehensive report" on e-cigarettes and smokeless. See decision FCTC/COP4(14) in .