More than 40 independent global health experts—including specialists in medicine, pharmacology, psychology, and public health—have issued a joint statement demanding the World Health Organization (WHO) embrace harm reduction strategies in its global tobacco policy.
The unified appeal, published on The Counterfactual’s ‘Expert Wall’, calls on the WHO and the Framework Convention on Tobacco Control (FCTC) Secretariat to make harm reduction central to controlling tobacco use worldwide.
The statement targets delegates at the WHO FCTC’s 11th Conference of the Parties (COP11) being held in Geneva, Switzerland from November 17 to 22, 2025. The experts argue the WHO’s current abstinence-only stance ignores the well-established continuum of risk, misinforms the public, and unintentionally protects the cigarette market. They recommend proportionate regulation and a science-led focus on smoking cessation.
“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.
Professor David Nutt of Imperial College London, called for a new policy direction. “Smoking causes a massive burden of death and disease worldwide, killing about 8 million people annually,” he stated. “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.” Professor Nutt added that current evidence confirms these products are much less harmful than smoking and can support cessation, urging the WHO to initiate a comprehensive policy review.
Former WHO Noncommunicable Disease (NCD) Surveillance Director Dr. Ruth Bonita said enabling smokers to switch from burned tobacco to safer smoke-free alternatives is crucial 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.
Professor Ann McNeill of King’s College London called on the WHO to stay true to its core values of independence, integrity, and compassion by “engaging openly with all credible scientists not just those who echo an ideological line.”
Dr. Andrzej Fal, president of the Polish Society of Public Health, believes the WHO’s “purist line” aiming to eliminate all nicotine use is a distraction from the urgent task of reducing smoking and saving lives. “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,” Dr. Fal noted.
Professor Neal Benowitz of Zuckerberg San Francisco General Hospital emphasized evidence supports non-combusted nicotine products as effective smoking cessation tools. “The FCTC’s focus should be to promote the elimination of cigarettes and other smoking products. Regulating nicotine is a far less compelling goal and should not distract from efforts to end smoking.”
Professor Kenneth Warner of the University of Michigan said data clearly show vaping helps smokers quit and failure to acknowledge this could cost lives. He cautioned that public health bodies emphasizing the potential risks of vaping among the youth—which he considers often exaggerated—may inadvertently undermine broader health outcomes.
Dr. K. Michael Cummings of the Medical University of South Carolina denounced the WHO for having a “blind spot” that makes it dismissive of scientific evidence on the reduced harm of non-smoked tobacco products. He highlighted that free-market access to safer nicotine alternatives in countries like Sweden, New Zealand, the U.S., and England has led to notable declines in smoking and improvements in public health.
