The Coalition of Asia Pacific Tobacco Harm Reduction Advocates (CAPHRA) has released a revision to their groundbreaking report ‘The Subversion of Public Health: Consumer Perspectives’, calling on governments worldwide to hold the World Health Organization (WHO) and the Framework Convention on Tobacco Control (FCTC) accountable for their exclusion of consumer perspectives in tobacco control policy discussions.

“This exclusion not only undermines public health efforts but also disregards the lived experiences and expertise of millions of former smokers who have successfully transitioned to safer nicotine products (SNPs),” said Nancy Loucas, Executive Coordinator of CAPHRA.

The Urgent Need for Inclusion

The WHO and FCTC have long championed tobacco control measures, yet their approach has been criticised for being overly rigid and dismissive of harm reduction strategies.

“Despite Article 1d of the FCTC, which explicitly includes harm reduction as a component of tobacco control, the WHO and FCTC have largely ignored this critical aspect. This oversight has led to policies that focus solely on supply and demand reduction, neglecting the potential benefits of SNPs such as e-cigarettes, snus, and heated tobacco products.”

"Consumers have first-hand experience of the dangers of smoking and the benefits of SNPs. Their exclusion from policy discussions is a dereliction of duty by the public health establishment. It is time for governments to demand that the WHO and FCTC include consumer groups in their deliberations," said Ms Loucas.

The Call to Action

To continue making progress in tobacco control, it is crucial to adopt standardised methodologies to track usage, conduct objective and comprehensive reviews of all data and science surrounding SNPs, and, most importantly, include consumer perspectives in policy discussions.

Policymakers must consider the evidence supporting SNPs and engage with consumers to develop sensible and effective guidelines. These include:

• Standardised Methodologies: Implement consistent and transparent methods to track the usage and impact of SNPs.
• Comprehensive Reviews: Ensure all scientific data, both positive and negative, is objectively reviewed and considered.
• Consumer Inclusion: Actively involve consumer groups in policy discussions to leverage their unique insights and experiences.

The CAPHRA report highlights several key points:

• Selective Evidence Review: The WHO and FCTC have been accused of cherry-picking evidence and excluding pro-harm reduction experts from discussions.
• Disenfranchisement of Consumers: Consumers are often dismissed as anecdotal or accused of being aligned with "Big Tobacco," despite their genuine advocacy for public health.
• Ethical Breaches: The exclusion of consumer perspectives violates several ethical principles, including the duty to society, beneficence, and non-discrimination.

“The time for change is now. Governments must hold the WHO and FCTC accountable for their failure to include consumer perspectives in tobacco control policies. By doing so, they can ensure that policies are not only scientifically sound but also reflective of the real-world experiences of those most affected by smoking and SNPs,” Ms Loucas said.

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