MORE than 40 global experts in medicine, pharmacology, psychology and public health have urged the World Health Organization (WHO) to adopt a harm reduction approach in its global tobacco control policy, saying current strategies fail to reflect scientific evidence.
The experts released the appeal through The Counterfactual’s “Expert Wall,” calling on the WHO and the Secretariat of the Framework Convention on Tobacco Control (FCTC) to put tobacco harm reduction at the center of international strategy.
Their statement is addressed to delegates who recently attended the 11th Conference of the Parties (COP11) in Geneva from November 17 to 22, 2025.
They argue that the WHO’s abstinence-only stance ignores mainstream research on the continuum of risk, misinforms the public, and inadvertently reinforces the cigarette market. The group is calling for risk-proportionate regulation, open scientific dialogue and a practical focus on ending smoking, not nicotine use.
"The goal of reducing the toll of death and disease caused by tobacco requires policies that accurately reflect the epidemiological evidence on the harms of different types of tobacco and nicotine products," said Dr. Robert West of University College London.
Dr. David Nutt of Imperial College London stressed the urgency of updating global policy. "Smoking causes a massive burden of death and disease worldwide, killing about 8 million people annually," he said. "We now have vaping and other smoke-free alternatives to cigarettes that can dramatically cut the risks for people who cannot or do not want to quit using nicotine."
WHO NCD Surveillance former director Dr. Ruth Bonita said smoke-free alternatives are essential to ending the global smoking epidemic. "Independent evidence, including real-world evidence from New Zealand, shows that regulated, reduced-harm smoke-free nicotine products can accelerate declines in smoking and prevent disease," she said.
Dr. Ann McNeill of King’s College London urged the WHO to honor its principles and "engage openly with all credible scientists, not just those who echo an ideological line."
Polish Society of Public Health president Dr. Andrzej Fal warned that a “purist line” targeting all nicotine use distracts from life-saving goals. "As a pragmatist and practitioner, I believe we should prioritize reducing disease and death, and that means we should focus on reducing smoking in any way we can," he said.
Dr. Neal Benowitz of Zuckerberg San Francisco General Hospital added that non-combusted nicotine products play a crucial role in cessation, emphasizing that the FCTC’s focus "should be to promote the elimination of cigarettes and other smoking products" and that regulating nicotine itself "is a far less compelling goal and should not distract from efforts to end smoking." (PR)