The WHO’s Tobacco Control Conference is Once More Silencing the Very People It Claims to Protect

The fight against smoking demands inclusion, not exclusion. Public health progress depends on evidence, dialogue, and ending dangerous groupthink tendencies.

As it draws closer, the World Health Organization’s Framework Convention on Tobacco Control (WHO FCTC) is once again facing mounting criticism ahead of its eleventh Conference of the Parties (COP11), which is scheduled for November in Geneva. Tobacco harm reduction (THR) experts warn that the conference’s increasingly closed-door approach and complex registration are set in place purposely to exclude the very stakeholders who could help save millions of lives.

The Coalition of Asia Pacific Tobacco Harm Reduction Advocates (CAPHRA) has condemned what it calls an “insane system” of public registration, designed not to welcome debate but to keep dissenting voices out. Executive Coordinator Nancy Loucas said the requirements—including detailed passport information, a formal letter of intent, a full curriculum vitae, and an explicit declaration of receiving no funding from tobacco companies—make it nearly impossible for independent consumer advocacy groups to participate.

While the FCTC cites Article 5.3 (intended to shield policy from tobacco industry interference) to justify such exclusion, critics say the WHO is now misusing this provision to block consumer groups, independent scientists, and harm reduction experts who have no industry ties but simply advocate for safer alternatives. For instance, while other global health forums, such as UN climate summits, welcome thousands of non-governmental organizations as observers, the FCTC has approved just 26 NGOs in two decades. Moreover, it has never granted formal access to consumer advocacy groups representing the very people who smoke or have switched to less harmful nicotine products.

This lack of openness is more than a procedural issue; it is a classic example of groupthink—a well-documented psychological phenomenon where decision-making bodies become insulated, suppress dissenting opinions, and reinforce pre-existing beliefs rather than consider evidence objectively. Among other things, groupthink can lead to policy blind spots, especially when experts who challenge the prevailing narrative are shut out. For a treaty designed to save lives, this is a dangerous dynamic. Policies crafted in echo chambers risk ignoring real-world data, alienating the people they affect, and driving consumers toward riskier, unregulated markets.

Evidence of the effectivity of harm reduction that cannot be refuted
At a recent Consumer Choice Center briefing in Manila, international health experts warned that the FCTC’s prohibitionist mindset is undermining public health progress. Speakers reiterated that nicotine itself, while addictive, is not the primary cause of smoking-related disease. It is the smoke from burning tobacco that delivers deadly carcinogens and toxins. And safer alternatives, which the WHO remains so staunchly against – remove combustion and drastically reduce harm.

Real-world evidence supports this. The drastic drops in smoking rates witnessed in countries who have endorsed these products for smoking cessation, such as Sweden, Japan and New Zealand, are population-level public health transformations. Yet the WHO FCTC continues to lump these reduced-risk tools together with cigarettes, advocating heavy restrictions and taxes that may push smokers back to combustible tobacco or into black markets.

Silenced voices Lost Lives
The stakes are not abstract. In countries like the Philippines, smoking-related diseases cost nearly $10 billion annually—around 2.5% of GDP. Studies estimate that if just half of Filipino smokers switched to lower-risk products, the nation could save more than $3 billion a year in healthcare and productivity losses. Similar modeling for India shows that embracing harm reduction could prevent 35–40 million premature deaths over 30 years.

Clinicians are also urging change. Doctors highlight that cigarette smoke drives not only lung cancer but also cardiovascular and urological diseases. Switching to smoke-free products dramatically reduces exposure to these risks. Yet many healthcare providers—especially in low- and middle-income nations—remain unaware of the harm reduction potential because the WHO continues to frame all nicotine use as equally dangerous.

Public shut out, progress shut down
Nancy Loucas argues that the WHO’s exclusion of consumers and harm reduction advocates undermines its stated commitment to human rights and public health. “The WHO cannot claim to take a human rights approach while silencing the very people their policies affect,” Loucas said. Advocates insist that meaningful progress requires democratic participation, where smokers who have successfully transitioned to safer options can share their lived experience and help shape evidence-based solutions.

Rather than suppressing debate, the FCTC should follow the lead of other global health conferences and embrace inclusive dialogue. Opening doors to a range of experts—including independent researchers, clinicians, and consumer voices—would allow the treaty to adapt to modern science and real-world evidence. If COP continues down its current path, it risks reinforcing an echo chamber that values ideology over outcomes. In tobacco control, that failure translates directly into preventable disease and death.

The WHO must rethink Its closed-door approach
The world’s smoking epidemic is evolving. Millions have already switched to less harmful alternatives; millions more could if policy supported rather than hindered them. As COP11 approaches, the WHO FCTC faces a defining choice: continue insulating itself from critical voices—or embrace transparency and collaboration to accelerate the end of smoking. For the sake of global public health, it’s time to break free from groupthink and invite all stakeholders to the table.