Guess WHO? Vaping, harm reduction & the World Health Organisation

Is the WHO a dysfunctional organisation?

Before trying to understand the words and actions of the WHO, it’s worth taking a look at some of the very strange things they have said and done over the years. 

· Praised North Korea for its lack of obesity. (This is a brutal totalitarian state which, at one point, lost 9% of its population to famine.) 

· Initially advised that Covid-19 was not infectious, even as China was starting to admit it might be. 

· Later dragged its feet on calling Covid a pandemic, which meant early vital funds could not be unlocked. 

· Tried to make a tyrant who destroyed his own country’s health system its goodwill ambassador. 

· Spends more on travel expenses than its complete spending on AIDS, tuberculosis and malaria. 

The WHO has a potentially valuable role to play. This is the organisation that wiped out smallpox. It virtually eliminated polio. It warned of the possibility of a global pandemic long before Covid struck. 

But unfortunately, as with vaping, it has a tendency to put its foot in its mouth. While people take the WHO seriously, it’s damaged its own credibility enough times that, for now, we need to take what it says with a large dollop of salt. 

The WHO and harm reduction

As you’ll see in this article, the WHO appears to be very anti harm reduction. 

Yet harm reduction is embedded into the guidelines to which the WHO is supposed to operate. 

…”tobacco control” means a range of supply, demand and harm reduction strategies that aim to improve the health of a population by eliminating or reducing their consumption of tobacco products and exposure to tobacco smoke.

What the WHO has said on vaping

Despite that, the WHO has been consistently negative on electronic cigarettes. 

The organisation talks about the harms of vaping without mentioning the relative harms compared to tobacco products. 

For example, they say:

ENDS emissions typically contain nicotine and other toxic substances that are harmful to both users and those exposed to the vapours secondhand.

This ignores that: 

· Nicotine (not tobacco smoke) has a similar risk profile to coffee.

· Toxic substances in vapour are at levels of magnitude lower than cigarettes. 

· They also say:

Both tobacco products and e-cigarettes pose risks to health and the safest approach is not to consume either.

This is correct. However, it ignores the fact that some people are addicted to nicotine and need to use one or the other. When you accept this, it makes sense to recommend the option which is at least 95% safer. 

The WHO doesn’t seem to get that, and indeed bemoans the fact that people are switching from smoking to vaping, stating:

Many countries across the European Region have struggled to contain the rising popularity of these products, and instead have simply seen a transferral of nicotine addiction from tobacco products to e-cigarettes.

The WHO also seems to cherry pick evidence to suit their stance. For example, they:

· quoted a key study that showed vaping is harmful to the heart – even after that study was retracted

· linked nicotine vaping to lung disease in the US, even though this was caused by Vitamin E acetate in black market cannabis.

Q: Do e-cigarettes cause lung injuries?
A: There is growing evidence to show that e-cigarettes use could cause lung damage.
At least 6 countries have initiated investigations to identify cases of lung injuries related to e-cigarettes use https://t.co/S8ZHoux45e pic.twitter.com/657bktQK8j

— World Health Organization (WHO) (@WHO) January 21, 2020

Many of the WHO’s statements on vaping have been thoroughly debunked in an excellent piece by Clive Bates, former head of the UK Action on Smoking and Health (ASH).

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