The reality of tobacco control
To have a law does not mean that it will be respected
Greetings from Panama City where the World Health Organisation is holding its latest conference. The 10th Conference of the Parties of the WHO Framework Convention on Tobacco Control — COP10 is the much needed abbreviation — was meant to be held in November but was cancelled as a result of local unrest and organisational incompetence.
I am not at the conference. I would not be welcome. Aside from the delegates and a bunch of anti-nicotine NGOs, hardly anyone is welcome at the conference. The WHO has a habit of turning away journalists, members of the public and experts who disagree with the agency’s hostile stance towards e-cigarettes. In contrast with last year’s COP28 conference of climate change, COP10 is not awash with politicians and the media. While fossil fuel giants like BP and Exxon showed up at COP28, the idea of a tobacco or vape manufacturer being allowed at COP10, even as a mute observer, is unthinkable.
The notorious secrecy of these meetings makes conventional news coverage challenging. Only the opening speeches are live-streamed and the organisers didn’t even manage to do that this year. Journalists locked out of the conference centre have to feed off scraps. This week’s big stories, such as they are, are that the WHO is attempting to use the war on single-use plastics to ban cigarette filters and that the small Caribbean nation of St Kitts and Nevis tabled a motion to set up a working group on tobacco harm reduction. Banning cigarette filters would be a de facto ban on cigarettes since tobacco companies cannot bring tar and nicotine yields within regulated limits without them. St Kitts’ brave stand looks like being a doomed and lonely mission since even the likes of the UK, which officially supports safer alternatives to cigarettes, lacks the courage to stand up to WHO bureaucrats and say “I’m Spartacus” (the UK delegation’s main contribution this week has been to boast about Rishi Sunak’s forthcoming crackdown on vaping).
Walking around Panama City teaches you more about the WHO’s approach to tobacco control than anything you will hear at the conference. Panama has done everything the WHO has recommended. E-cigarettes are not only illegal to sell, but are illegal to use. Smoking is banned almost everywhere, including on roof top bars and within two metres of buildings. No smoking signs are invariably accompanied by no vaping signs. Tobacco is heavily taxed and tobacco products come with graphic warnings.
Panama has a low smoking rate but it had a low smoking rate long before it introduced any of these policies. What it also has is an extraordinarily large black market in tobacco. 92 per cent of all cigarettes sold are counterfeit, a fact that is bizarrely advertised by Panama’s health department on billboards. Single cigarettes and cigars are sold by children on the street. Unregulated vaping products are openly sold on street corners. Despite the sale of e-cigarettes being illegal, I saw an advertisement for one in the middle of Panama City. The laws on smoking and vaping in public are casually and routinely flouted, especially in bars. On paper, Panama is a model of neo-prohibitionist tobacco control. That is why the WHO decided to come here. But outside the conference centre, the reality is very different.
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