COP11: The Battle of Ideology and Science

Core insight: Global tobacco control is facing a profound paradigm shift. The eleventh session of the Conference of the Parties (COP11) to the Framework Convention on Tobacco Control (FCTC), led by the World Health Organization (WHO), has evolved into a critical battlefield, with its rigid prohibitionist ideology forming a sharp opposition to the “Tobacco Harm Reduction” (THR) strategy based on scientific evidence, represented by the United Kingdom. This is not only a policy debate but also a severe test of the future direction of global public health and the credibility of the organization itself.

Driving factors:

• The fundamental opposition of ideology: The core of the conflict stems from two completely different public health philosophies. One side, represented by Belgium and the WHO Secretariat, views all new nicotine products as a public threat and aims to eradicate them. On the other hand, the pragmatic harm reduction faction led by the UK sees alternatives such as electronic cigarettes as effective tools to help adult smokers quit smoking and reduce health risks.
• The division of success and failure in national practice: Countries represented by the United Kingdom and Sweden have lowered their smoking rates to historic lows by adopting harm reduction strategies. These successful real-life cases stand in stark contrast to countries such as Belgium that have implemented strict restrictions but still have a smoking rate of up to 20%, challenging the theoretical authority of WHO through evidence-based policies.
• The closure and inertia of institutions: The FCTC Conference of Parties has been criticized for its “closed door” decision-making, which seriously lacks transparency. This culture of “groupthink” that excludes independent scientists, consumer representatives, and advocates for harm reduction has led to its adherence to traditional prohibitions and difficulty in accepting and evaluating the public health opportunities brought about by disruptive innovation.
• The financial influence of key member countries: As an important sponsor of WHO (contributing approximately £170 million annually), the UK’s position has significant influence. This not only gives it motivation but also a responsibility to defend its successful, science-led harm reduction policies on the international stage, thereby exacerbating tensions with the mainstream line of the WHO.

Key evidence:

• Policy stance comparison: “In stark contrast to Belgium’s readiness to lead a boycott of new nicotine products, the UK is preparing to reaffirm its position as one of the world’s leading defenders of tobacco harm reduction (THR).”
• Public health effectiveness: Despite extensive restrictive measures, Belgium’s smoking rate remains at around 20%, one of the highest in Western Europe. At the same time, “7.5 million people” still die from smoking worldwide every year. Countries that adopt harm reduction strategies, such as Sweden and the United Kingdom, have achieved record low smoking rates.
• WHO official position: According to reports, under agenda item 4.5, “the WHO Secretariat’s own briefing document completely denies harm reduction methods,” which directly indicates the organization’s official bias.
• Lack of Transparency: The COP conference has only 29 observer organizations certified, while the United Nations Climate Change Conference has over 4000. This data clearly reveals the closed nature of its decision-making process.
• Expert Warning: Live Bates warns that the current direction of FCTC “may exacerbate failures rather than promote public health.” He explicitly stated that unless FCTC embraces science again, COP-11 may be remembered as another missed opportunity.”

Strategic insights:

COP-11 is not just a regular meeting, but a turning point in the global tobacco control strategy. WHO’s FCTC is facing a ‘legitimacy crisis’: if ideology continues to be placed above scientific evidence and successful practices, its leadership and moral authority in global public health will be severely weakened. In the future, global tobacco control may move towards fragmentation, forming a “harm reduction innovation” camp led by countries such as the UK and a “traditional conservative” camp following WHO bans. The final decision is whether to choose a stagnant ban or embrace technological innovation that can save millions of lives. The outcome of this game will redefine the global public health landscape for the next decade.