The taxpayer-funded World Health Organization (WHO) recently released new guidelines on smoking cessation that conspicuously exclude the use of e-cigarettes and heated tobacco products. Despite the evidence supporting their effectiveness in helping smokers quit, the WHO’s stance appears more rooted in bureaucratic comfort than in genuine concern for public health. This omission reflects a troubling disconnect between the WHO’s recommendations and the growing body of evidence that demonstrates the efficacy of these harm reduction tools.
In 2021, Varenicline (a smoking cessation drug) was withdrawn from the market due to unacceptably high levels of a nitrosamine impurity called N-nitroso-varenicline, a probable carcinogen. Despite this, the WHO’s new guidance recommends it as a first line product for cessation practitioners. This decision is baffling given the significant health risks associated with Varenicline (plus its lack of availability worldwide) and the proven effectiveness of alternative products such as vapes, nicotine pouches, and snus.
The WHO has acknowledged the potential of safer nicotine products in one of its own reports in 2016, saying that “if the great majority of tobacco smokers who are unable or unwilling to quit would switch without delay to using an alternative source of nicotine with lower health risks … this would represent a significant contemporary public health achievement.”
Yet, the WHO seems determined not to seize the opportunity that reduced risk products present for smoking cessation. The exclusion of e-cigarettes from their latest guidelines contradicts this earlier admission and disregards the increasing evidence supporting their efficacy over and above traditional
