Global Tobacco Control: A Battle between Ideology and Science

Core insight: Global tobacco control policies are at a critical crossroads. The upcoming COP11 conference will be a fierce confrontation between the deeply rooted ideology of injunctions and the emerging strategy of scientific empirical harm reduction. This will not only determine the direction of global tobacco control policies in the coming years, but also directly test the scientific authority and credibility of the World Health Organization (WHO) in the field of public health.

Driving factors:

• Fundamental policy divergence: Traditional forces represented by Belgium view new nicotine products such as e-cigarettes as a “threat” to public health and advocate for a comprehensive ban. The reformists represented by the UK see it as an “opportunity” and important public health tool to help adult smokers quit smoking.
• A stark contrast in national practice: The UK has achieved record low smoking rates by promoting Tobacco Harm Reduction (THR). In contrast, countries such as Belgium that have implemented strict restrictions still have a high smoking rate of around 20%. The difference in practical effects has intensified the opposition between the two sides on the international stage.
• Institutional inertia and lack of transparency: The COP conference has been criticized as a “closed door” decision-making process that excludes the voices of independent scientists, consumer representatives, and advocates for harm reduction. This ‘groupthink’ and institutional opacity make evidence-based policy reforms difficult to shake the existing prohibitive framework.
• The game of influence and resources: As one of the main funding countries of WHO (contributing approximately £170 million annually), the UK’s position carries considerable weight. At the same time, the ban route requires a huge amount of funding of up to 9.6 billion US dollars per year, while the harm reduction strategy can significantly reduce public costs through consumers’ self payment conversion, which implies profound economic considerations.

Key evidence:

• Opposing positions: The Belgian Deputy Prime Minister will host a global seminar against new nicotine products, while the UK Department of Health has confirmed that its delegation will once again emphasize that “electronic cigarettes are far less harmful than smoking and are an effective smoking cessation aid”.
• Data support: Despite decades of strict tobacco regulations, 7.5 million people worldwide still die from smoking every year. At the same time, countries such as Sweden and the United Kingdom have reduced smoking rates to historic lows by adopting harm reduction measures.
• WHO official inclination: According to reports, the WHO Secretariat completely rejected tobacco harm reduction methods in the meeting agenda document (item 4.5), which has sparked sharp criticism from researchers and public health advocates.
• Closed decision-making environment: The COP conference only accredited 29 observer organizations, while the United Nations Climate Change Conference had over 4000. This extreme exclusivity has led to accusations of ‘scientific isolation’.
• Expert Opinion: Policy expert Clive Bates explicitly stated in his “COP11 Representative Survival Guide” that “bans cannot save lives, innovation is what can”.

Strategic insights: COP11 is far more than just an international conference on e-cigarette regulation, it is essentially a key “stress test” for global public health strategies. The results of the meeting will reveal whether WHO and its member states choose to adhere to rigid traditional bans or embrace more pragmatic and results-oriented harm reduction innovations when faced with disruptive technologies and overwhelming scientific evidence. If WHO continues to reject harm reduction strategies, its credibility and moral authority as a global health leader will face serious erosion. On the contrary, if rational voices led by the UK can guide debates back to science and evidence, COP11 may mark a new chapter in global public health – a new era that ultimately shifts the focus from ideology to practical impact.