World Health Organization’s Misguided Call for E-Cigarette Flavor Ban

This analysis is based on breaking news and will be updated. To connect with the author, please e-mail [email protected].

The World Health Organization (WHO) is calling for urgent action against e-cigarettes in an effort to protect youth. In today’s press release, they argue e-cigarettes are not effective for smoking cessation and harmful to health. It is a good thing WHO guidance is non-binding because, in their pursuit to protect youth, they are abandoning one billion smokers globally.

Protecting youth must, of course, be a priority. In the United States, for example, our laws restrict the purchase of tobacco or nicotine-containing products to individuals 21 years of age and older. Raising the national age to purchase these products, coupled with effective enforcement, has been key to reducing youth use. In 2019, the year Tobacco 21 (T21) was enacted, the prevalence of e-cigarette use by high school students was nearly 28 percent. Since the establishment of the T21 law, the United States has seen continued declines in youth use of e-cigarettes year over year, dropping to only 10 percent in 2023.

Strong regulations on advertising, marketing and packaging are effective for ensuring these products are not targeted toward youth. However, prohibition-styled efforts—much the same as WHO proposes—have resulted in an illicit market of disposables that regulators have been unable to address properly. It is perhaps unsurprising that flavored disposables are now the product of choice for youth. Another avoidable regulatory misstep was fear-based prevention programming for youth that has inadvertently increased risk misperceptions among adult smokers who now believe e-cigarettes are at least as harmful as traditional combustible cigarettes.

It is precisely this population that has the most to lose from WHO’s position on e-cigarettes. Their claim that “E-cigarettes as consumer products are not shown to be effective for quitting tobacco use at the population level” is misleading at best. The reality is that there is ample evidence e-cigarettes are highly effective tools for smoking cessation—more so than traditional nicotine replacement therapies (NRT). Through the careful wording of “consumer products,” WHO is undermining that evidence on a technicality that the data emanates from controlled experiments and not generalized population use. Additionally, WHO calls for countries to “exhaust” proven cessation strategies without paying deference to the fact e-cigarettes are showing to be more effective than traditional NRTs. To advocate for outdated and less-effective therapies as a first line of defense is a disservice to public health.

The truth is that there is no one-size-fits-all approach to tobacco control, given differences in population demographics, burdens of disease, and cultural and socioeconomic factors. It is also true that e-cigarettes are an effective smoking cessation tool in the arsenal to reduce global cigarette consumption. These truths do not seem to matter to WHO as they risk further undermining their credibility through promotion of prohibition-styled regulations. If there exists a successful example of prohibition, WHO should bring that forward. But in the interim, they would be wise to put evidence before politics.