Global harm reduction experts are calling on the World Health Organization (WHO) to reconsider its tobacco control policy, citing its failure to significantly reduce smoking rates and tobacco-related deaths worldwide.

Panelists at the 2025 Global Forum on Nicotine (GFN) in Poland encouraged the WHO and governments globally to adopt harm reduction and human-centered policies. They said this approach would more effectively help over a billion smokers quit or switch to less harmful alternatives that include heated tobacco, nicotine pouches and e-cigarettes.

A panel titled "Reflections on the Framework Convention on Tobacco Control at 20" brought together prominent voices in public health, oncology and consumer advocacy to assess two decades of global tobacco control efforts.

GFN panelists underscored the need to reframe tobacco control around science, equity and human rights, advocating for a new policy era that embraces harm reduction, supports consumer choice and respects the experiences of those most affected. They said it is time to move beyond prohibitionist policies towards pragmatic, evidence-based approaches prioritizing harm reduction, innovation and individual dignity.

Distinguished experts on the panel included Professor Tikki Pangestu, former WHO Director of Research Policy & Cooperation and now Visiting Professor at the Yong Loo Lin School of Medicine, National University of Singapore; Asa Saligupta, director of ENDS Cigarette Smoke Thailand (ECST); Dr. Derek Yach, who served as WHO cabinet director and executive director for noncommunicable diseases and mental health, where he was instrumental in developing the Framework Convention on Tobacco Control (FCTC) and global dietary guidelines; Professor David Khayat, a French oncologist and founder of the Paris Charter Against Cancer; and Jeannine Cameron, founder and managing director of JCIC International Consultancy.

Pangestu cited the structural challenges faced by low- and middle-income countries (LMICs) in forming independent tobacco policies, noting their significant susceptibility to WHO influence. "The elephant in the room is the WHO," Pangestu said. "As long as that position doesn't change, many countries are going to continue with apathy."

Saligupta criticized the influence of Bloomberg Philanthropies and certain non-governmental organizations in shaping restrictive tobacco policies promoted by the WHO. "They use ideology over evidence, they’re ignoring science and pushing prohibition," Saligupta said.

Saligupta stressed the importance of consumer access to safer alternatives, warning that misinformation and regulatory overreach, often driven by well-funded international actors, undermine public health goals in countries like Thailand, where importing or distributing vaping products remains illegal.

Yach reflected on the FCTC, which he helped design during his time at the WHO, underscoring the importance of local efforts and participation in countries where these discussions occur, rather than relying solely on the high-level bureaucracy in Geneva.

While acknowledging the treaty's historical significance, Yach noted its uneven and underfunded implementation. He said the treaty's failure to embrace harm reduction has limited its impact, particularly in countries with persistently high smoking rates.

Khayat compared the FCTC and the Paris Charter Against Cancer, which he co-authored in 2000. "Cancer patient rights are human rights," he said, emphasizing that public health policy should be rooted in compassion, education, and respect for individual dignity.

Khayat criticized the "quit or die" binary framing of risk in tobacco control as unrealistic and counterproductive for those struggling with addiction. Instead, he advocated for policies supporting informed choice and access to innovation.

Cameron reminded the audience that meaningful change should originate from national governments, not international bureaucracies. "The WHO gets to decide nothing. It’s the national governments that must act," Cameron said.

She said that while the WHO can set agendas and publish reports, ultimately, sovereign states are responsible for adopting and implementing policies.

In the Philippines, Dr. Lorenzo Mata Jr., president of the advocacy group Quit for Good, supported the call for a shift in the WHO's approach. "The WHO has fallen short of its target and failed to help more than a billion smokers globally," Mata said.

"Because of its prohibitionist ideology, the WHO has only alienated smokers and nicotine consumers, demonizing them for their habits. It is time for the WHO to adopt a more compassionate approach and acknowledge the rights of consumers to choose what is best for them," said Mata.