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November 10th, 2016:

WHO discusses ENDS, continues taking fight to tobacco industry

As the World Health Organization’s seventh Conference of the Parties (COP7) in India reached its halfway mark on Wednesday, the WHO was busy pushing for all loopholes to be closed in article 5.3 of the Framework Convention on Tobacco Control (FCTC).

The article states: “In setting and implementing their public health policies with respect to tobacco control, Parties shall act to protect these policies from commercial and other vested interests of the tobacco industry in accordance with national law.”

The WHO believes this should be given a broad interpretation, meaning that tobacco companies should be excluded entirely from discussions of policy and from events such as COP7.

Meanwhile, the WHO’s hostile tone continued unabated, with Big Tobacco and all pro-tobacco advocates being labelled bullies and trolls on Twitter.

Also at the conference, discussion of electronic nicotine delivery systems (ENDS) and electronic non-nicotine delivery systems (ENNDS) – terms in which the WHO includes e-cigarettes – and water pipe tobacco products continued.

The WHO has been highly critical of vaping and has also attacked the tradition of inhaling tobacco through the water pipe as extremely harmful.

Down on the farm

But agriculture remained a major focus, illustrating how the WHO may have to balance health ideals with economic realities.

Tobacco farms have become major employers across the world, and one of the stumbling blocks in the WHO’s drive toward a tobacco-free world is the loss of livelihood for millions of people involved in the growing industry.

As a result, one of the subjects being discussed at the event in Noida, near New Delhi, is economically-sustainable alternatives to tobacco growing.

In a report by the FCTC earlier this year, alternative pilot projects and new and better practices were outlined and their implementation urged. With pro-tobacco lobbies warning of reduced employment and damaged economies, the convention secretariat said: “In reality, annual consumption usually decreases by fractions of percentage points, thus allowing growers to gradually diversify into other activities as government adjustment programmes are implemented.”

Yet fewer than a quarter of nations that are parties to the treaty have made tobacco-growing alternatives a priority.

“Plenty of crops are available, from vegetables to fruits. Alternate livelihoods should be seriously explored and supported through appropriate marketing interventions which involves multiple markets and agencies,” said one delegate, who refused to be named.

Paying the lawyers

The issue of liability is also under discussion. The WHO has committed itself to provide legal help for civil and criminal litigation against tobacco companies. According to the WHO FCTC, providing tools to the 180 parties that have signed the treaty is giving them an opportunity to “avail themselves of effective means to hold the tobacco industry liable”.

Each party has to submit the progress it has made in building databases of information, engaging lawyers, and so on, and also propose how they should be subsidised.

Reducing global tobacco consumption by 30% by 2025 remains one of the most important agenda items for the WHO FCTC.

– Swati Gupta ECigIntelligence contributing writer

Africa: Uganda Team Kicked Out of WHO Meeting

A team of Ugandan officials were on Monday blocked from attending a tobacco control meeting adding to a series of diplomatic embarrassments where senior government personnel have been denied entry into WHO meeting venues on the orders of their own government colleagues.

Last month, delegates from the Trade Ministry including MPs were kicked out of a World Health Organisation (WHO) Framework Convention on Tobacco Control (FCTC) meeting in the Algerian capital of Algiers.

A similar incident happened two years ago in Moscow, Russia where a Ugandan delegation was kicked out of similar meetings for lack of coordination.

Daily Monitor understands that officials who include MPs were blocked from registering for the India conference on the orders of Dr Sheila Ndyanabangi, the Programme Manager for Mental Health and Substance Abuse in the Ministry of Health who is also the “focal person” for the meeting.

The MPs who were blocked included Jalia Bintu (Masindi District Woman MP) Lowila Oketayot (Pader District Woman MP), Isaac Etuuka (Madi Okolo) and Dan Muheirwe (Buhaguzi County, Hoima). Mr Abdul Kasule the Assistant Commissioner for Trade in the Ministry of Trade, Industry and Co-operatives was also blocked.

Before departure for the meeting, Dr Ndyanabangi had told Daily Monitor in an interview that she was prohibited by law from engaging with any of the tobacco industry players and their promoters.

Only officials on a nomination list issued by outgoing Ministry of Health Permanent Secretary Dr Asuman Lukwago on August 26, were allowed to access the meeting venue.

Those nominated by Dr Lukwago were drawn from the Ministry of Health, Uganda National Bureau of Standards, Ministry of Finance and NGOs fighting tobacco consumption such as the Bill and Melinda Gates Foundation- backed Centre for Tobacco Control in Africa which had three out of the 14 officials on the Ministry of Health delegation. They were led by Dr Ndyanabangi.

According to a source at the meeting who declined to be named because they are not authorised to speak to the media, Mr Etuuka presented his credentials to the security at the meeting venue in New Delhi but as he was being registered and accredited, Dr Ndyanabangi appeared with the list and denied him access, citing the orders of the Permanent Secretary of Ministry of Health.

Mr Etuuka and his colleagues had their documents, authorising them to attend the meeting, withdrawn and they were subsequently barred from attendance.

Attempts by the politicians to meet Uganda’s High Commissioner Ms Elizabeth Napeyok on Monday, were futile. One of the blocked MPs told this newspaper that Ms Napeyok informed them through Ms Deborah Kembabazi, the administrative attaché at the High Commission, that she would not meet them.

However, after consultations, the legislators yesterday met Ms Napeyok, who informed the team that it was not possible for her to assist them to make any changes to the delegation composition.

According to a source privy to the meeting, Ms Napeyok informed the legislators, that she would be writing to Foreign Affairs Minister Sam Kuteesa explaining her constraints.

The MPs were also advised to write to the office of the Speaker of Parliament, the Clerk to Parliament and copy in the Ministry of Foreign Affairs and Trade protesting their being blocked from the meeting.

Mr Kasule was also advised to file a report to his superiors in Kampala protesting the incident. When contacted, Chris Obore, the Parliament’s Director of Communications and Public Affairs, said the House leadership was yet to be informed about the incident.

“When they (MPs) write, that is when Parliament will know and relevant action will be taken,” he said.

Monday’s incident was yet another in a row between officials of the Health Ministry on one hand and several other government departments and tobacco farmers on the other over Uganda’s representation at meetings of that nature.

Ministry of Health officials have made it clear that their position to block the legislators or any person involved in the promotion of tobacco growing and trade is guided by Article 5.3 of the WHO FCTC which stops member countries from nominating “any person employed in the tobacco industry, or entity working to further its interests, or any person benefitting from proceeds of tobacco trade.”

Meanwhile, journalists too were not spared. They were also kicked out of the WHO meeting after delegates voted unanimously to ban the press from covering the conference, a move that has sparked wide condemnation from the media fraternity.


Plain packaging is tobacco packaging that is stripped of all promotional elements—no graphics, logos, colours, fancy fonts, or embellishments.

Elements of the packaging are also standardised, such as the size, shape, and opening style.

Although the precise regulations vary by country, what is striking is the similarity of the campaigns being waged by tobacco companies and their allies to prevent, weaken, or delay implementation. Indeed, on a recent speaking tour in Canada, former Australian Health Minister Nicola Roxon called the arguments and tactics being used by the Canadian industry “spookily similar” to those used to try to undermine plain packaging in Australia.

In Australia, right after the government announced plain packaging, the tobacco industry went on the attack to an extent not seen in public for decades. They developed campaigns operating on multiple platforms, including print, radio, television and point-of-sale, framed, on multiple arguments:

1. There is no evidence that plain packaging will work.
2. Plain packaging will increase illicit tobacco use.
3. Plain packaging will hurt small retailers.
4. Plain packaging is a ‘slippery slope’.
5. Plain packaging violates Australia’s legal obligations.

Similarly, in Canada, where plain packaging is currently under development, the tobacco industry has recently launched a multi-front offensive against the reform under the very same broad themes.

In addition to the same campaign themes, tobacco companies are using identical tactics around the world to try to undermine plain packaging. Because they lack credibility, the companies rely heavily on third parties to carry their messages. In Australia, a vocal opponent was the Institute of Public Affairs (IPA), a right wing think tank. The IPA has re-surfaced during the Canadian campaign, with Sinclair Davidson, an IPA affiliate, doing a speaking tour across Canada this autumn on “The Unintended Consequences of Plain Packaging: Reflecting on Impacts in Australia.”

Retailer associations are key players in the fight against plain packaging.

In Australia a retailer front group, the Alliance of Australian Retailers (AAR), led the tobacco industry’s campaign.

In response, Australian health groups published a half-page ad in a major Australian newspaper to expose the AAR as a sham organization that was fully funded and controlled by tobacco companies.

Likewise, Canadian health groups working with supportive journalists succeeded in exposing the Canadian Convenience Stores Associations and its regional affiliates as key players in Imperial Tobacco Canada’s long-term strategy to prevent anti-tobacco regulation in Canada, including plain packaging.

In both Australia and Canada, key to protecting the government’s plain packaging initiative from industry interference has been civil society countering industry lies with the facts and exposing the companies’ strategies, including their use of front groups. Going forward, vigorous implementation of Article 5.3 guidelines will help countries implementing plain packaging to minimize industry interference in the policy-making process. This includes requiring “the tobacco industry and those working to further its interests to operate and act in a manner that is accountable and transparent” (Principle 3) and raising “awareness about the tobacco industry’s practice of using individuals, front groups and affiliated organizations to act, openly or covertly, on their behalf” (Recommendation 1.2).

The same pattern of industry behaviour and the same arguments have been seen in every country that has introduced plain packaging legislation (Ireland, the UK, France, New Zealand) and will undoubtedly be seen in every country to follow.

The application of Article 5.3 guidelines can help insulate this important reform from the undue influence of the industry and its allies.

Moreover, countries that are heading toward plain packaging can now draw upon a wealth of evidence and experience to support implementation.

Plain packaging works, and the tobacco industry knows it.

Melodie Tilson
Non-Smokers’ Rights Association, Canada

Kylie Lindorff
Cancer Council Victoria, Australia


In 2014, the 6th Conference of the Parties (COP) adopted a voluntary global target for a 30-percent relative reduction in tobacco use prevalence by 2025. This goal will not be achieved unless steps to further implementation of the Framework Convention for Tobacco Control (FCTC) are taken immediately.

Parties are committed to implementation, and by including key priorities within the workplan, they can advance and accelerate harm reduction in time to meet this global deadline.

One of the steps to success will be creating and launching an implementation review committee as proposed under agenda item 6.1.

The committee would provide a systematic review of implementation reports and guidance on how to improve and accelerate efforts to reduce tobacco use prevalence.

The effectiveness of this committee would be furthered by allowing nations to share and monitor global progress on implementation through the creation of an expertdriven mechanism— an implementation review mechanism, or IRM- compile such information and report on the global progress.

However, implementation is not possible without adequate resources.

If they are to be effective, both initiatives must be adequately funded. Also, the Secretariat should be mandated to play an active role in mobilising resources for further implementation. Through a system of review, Parties’ needs could be identified, prioritized and formally communicated from the Secretariat to donors and potential donors.

The increased role of the Secretariat would allow for additional key strategies to be included in the workplan including:

• Travel support to meetings of the FCTC COP for low- and middle-income countries, so that those who bear the greatest burden of tobacco-related deaths are a part of the ongoing discussions;
• Support for the Protocol to Eliminate Illicit Trade Products (ITP) so that the Meeting of the Parties (MOP1) can take place swiftly after the treaty comes into force (after 40 countries sign on);
• A knowledge hub for Article 5.3 that would track tobacco industry interference in political systems around the world.

To carry out these crucial and necessary activities, FCA recommends that the Secretariat’s budget proposal be adopted with the proposed increase in the Voluntary Assessed Contribution.

FCA also proposes that the FCTC workplan create an ongoing, multistakeholder finance dialogue, similar to that of the World Health Organization (WHO) in order to assist the Secretariat in further identifying and addressing member resource needs.

While these discussions may be difficult, the workplan and budget must reflect implementation plans and provide adequate resources if the FCTC hopes to save the lives it has fought so hard for., guidelines alone are not enough.


In the midst of a COP week, it’s easy to lose perspective on just how much the FCTC has already achieved – and on how that achievement happened.

Not so long ago, when the FCTC was adopted, the idea of smokefree bars and restaurants was outlandish in most countries. Now it’s a reality in many places.

Not so long ago, health warnings in most countries were messages in small type, barely visible on the side of the pack. Now many, many Parties have graphic health warnings, covering half the pack or more.

A key ingredient to this rapid spread of FCTC-grounded policies was the guidelines process.

Hashing out the details of policy recommendations on these issues, in working groups and then at COP sessions, may have seemed like frustrating, hard work at the time.

But in the process, Parties learnt from each other, from experts and from civil society, about what does and doesn’t work, about what has the biggest impact, about the pitfalls that regulators face. Parties helped each other to achieve giant steps in tobacco control policy.

Implementation review is an extension of the same idea:

Parties helping each other, in this case to overcome the numerous implementation difficulties that most countries still face. An implementation review committee (IRC), made up primarily of Parties, would look at individual reports and identify Parties that appear to be facing particular problems implementing the FCTC. The committee would then follow up with those Parties individually to scope out the underlying problems and see what can be done to help fix them.

In the process, the committee would gather lots of information on Parties’ shared implementation problems, which it would in turn synthesise and report back to the COP.

There are many advantages to this kind of mechanism. First, it would give clear purpose to the biennial task of filling in the lengthy FCTC reporting instrument: identifying Parties most in need of help.

Second, in some cases Parties simply need structured advice, based on best practices from other countries, in order to overcome some types of obstacles. (Example: setting up an inter-ministerial FCTC committee that has real buy-in from non-health ministries.)

Third, where it becomes clear that Parties need technical assistance or more resources, implementation review would help in identifying what exactly the biggest needs are. And that in turn provides an excellent fund-raising tool for FCTC implementation.

Implementation review mechanisms (IRM) are common amongst international treaties. There are many different models; it’s important to think how the FCTC one should work, as the drafting group working on this issue will no doubt be doing.

In some treaties, such mechanisms may be primarily about providing a way for Parties to check up on each other. For example, a treaty may have quite a muscular IRM to
enforce compliance.

The FCTC is not like that: the vast majority of Parties are full of good will and trying to do their best to combat a major public health problem. For the most part, they
generally have little interest in checking up on their neighbours.

Instead, they want to learn from eachother.

Accordingly, implementation review for the FCTC should be about mutual support. This is baked into the Terms of Reference proposed by the expert group on reporting, which specifies that the proposed IRC “shall be objective, facilitative in nature… shall make non-binding recommendations, and be focused on assisting Parties…”

Mutual assistance is what got the FCTC this far – it’s crucial to allow Parties to collectively overcome their remaining implementation challenges.

Just ONE puff of flavoured e-cigarette vapour ‘contains dangerous levels of cancer-causing chemicals’

Flavoured liquids used in the devices exposes smokers to “unacceptably high” levels of aldehydes, produced when a compound decomposes

JUST one drag of a flavoured e-cigarette exposes a smoker to “unacceptably high” levels of cancer-causing chemicals, experts warned today.

They found aerosols – commonly called vapours – produced by the devices contain the dangerous substances.

These toxic aldehydes, including formaldehyde, are produced during the chemical breakdown of the flavoured e-liquid during the rapid heating process that happens inside e-cigs.

Dr Andrey Khylstov, of the Desert Research Institute, Las Vegas, said: “One puff of any of the flavoured e-liquids that we tested exposes the smoker to unacceptably dangerous levels of these aldehydes, most of which originates from thermal decomposition of the flavouring compounds.”

His team found the production of toxic aldehydes “is exponentially dependent on the concentration of flavouring compounds”.

E-cigarette liquids are marketed in nearly 8,000 different flavours, according to a 2014 report by the World Health Organisation.

Recent reports show many of these flavours, such as Gummy Bear, Tutti Fruity, and Bubble Gum, to name a few, are especially appealing to teens and kids – encouraging them to use the devices.

Around 2.8million adults use the devices in the UK and a 2014 study revealed more kids aged 11 to 15 experimented with e-cigs than traditional cigarettes.

In the US, 16 per cent of high school students regularly vape – making them the most commonly used tobacco product in teenagers.

To examine the dangers, Dr Khylstov and his team measured the levels of aldehydes in vapour produced by three common e-cigs.

To determine if flavourings were to blame for producing the cancer-causing chemicals, the researchers tested five flavoured liquids, as well as two control unflavoured liquids.

Researcher Dr Vera Samburov explained: “To determine the specific role of the flavouring compounds we fixed all important parameters that could affect aldehyde production and varied only the type and concentration of flavours.”

She said the devices used in the experiments were three of the most common types of e-cig.

Using a controlled system, the researchers were able to ensure the same level of “puff” each time, simulating common vaping conditions.

All tests revealed the level of cancer-causing chemicals produced by flavoured e-liquids exceeded limits set by American authorities, designed to protect against hazardous chemical exposure.

Dr Khylstov added: “These results demonstrate the need for further, thorough investigations of the effects of flavouring additives on the formation of aldehydes and other toxic compounds in e-cigarette vapours.”

The findings are published in the journal Environmental Science and Technology.