A new report issued by the World Health Organization (WHO) finds that countries have made significant progress in the fight against the tobacco epidemic. However, this progress is threatened by continued tobacco industry interference and the tobacco industry’s ongoing efforts to introduce new nicotine and tobacco products, which many countries are failing to effectively regulate.
 
The WHO Report on the Global Tobacco Epidemic 2021 – a biannual report – highlights the increasingly complex threats to global public health caused by the introduction of new nicotine and tobacco products. Most concerningly, the report finds:
 
There are approximately 16,000 unique e-cigarette flavors available in some markets, many of them appealing to children. Studies in the United States show that flavors play a major role in e-cigarette use amongst children and adolescents.
Children and adolescents who use electronic nicotine delivery systems (ENDS) are more than twice as likely to use conventional cigarettes
There is growing evidence of the harmful effects of ENDS, including on cardiovascular and respiratory health, on brain development of adolescents, and among smokers who engage in dual use or who delay overall quitting, and
The evidence of the potential role of e-cigarettes on quitting, especially on a population basis, remains inconclusive.
This is no accident, as the WHO report finds that tobacco and ENDS companies use product designs and marketing strategies that appeal to young people, including the use of thousands of attractive flavors and social media influencers to addict the next generation of tobacco users.  
 
According to the new report, 32 countries have banned the sale of electronic nicotine delivery systems (ENDS), covering 2.4 billion people. Another 79 have implemented partial measures to regulate the products, covering 3.2 billion people. It is crucial that more countries effectively regulate e-cigarettes and heated cigarettes to ensure that these products do not fuel the next generation of tobacco users. 
 
In the U.S., youth e-cigarette use remains an enormous problem – 3.6 million kids used e-cigarettes in 2020, including 1 in 5 high school students. A growing percentage of them did so frequently or daily, a sure sign of addiction. With 83% of youth e-cigarette users using flavored products, the evidence is clear that flavored e-cigarettes have driven this epidemic. These high rates of youth e-cigarette use underscore the fact that as long as any flavored e-cigarettes remain on the market, kids will get their hands on them and the epidemic will continue unabated. As it considers applications from e-cigarette makers to keep their products on the market, the U.S. Food and Drug Administration should not allow the sale of any flavored e-cigarettes.
 
As the world continues to face the COVID-19 pandemic, it has never been more critical for governments to adopt effective tobacco control policies, as mounting evidence suggests that tobacco users have a significantly higher chance of developing severe COVID-19 complications compared to non-smokers. The WHO report notes that tobacco companies like Philip Morris International and British American Tobacco have exploited the global pandemic to aggressively market tobacco and nicotine products to young people around the world. The new WHO report should serve as a call to action for countries around the world to stand up to Big Tobacco’s deceptive strategies. 
 
Despite the challenges posed by big tobacco companies, extraordinary progress has been made in the fight against tobacco use. More than half of all countries now require graphic health warnings on tobacco packaging at the best-practice level defined by the WHO. 
 
Despite the progress that has been made in the global fight against tobacco use, countries must take even greater action to end the tobacco epidemic. To continue the life-saving progress documented in the WHO report, it is imperative that countries fully implement the proven tobacco control solutions called for by the WHO Framework Convention on Tobacco Control (FCTC), the world’s first public health treaty signed by 181 countries. The treaty obligates countries to pass evidence-based measures including increased tobacco taxes, warning labels on tobacco products, 100 percent smoke-free public places, and bans on tobacco marketing. Without urgent action, the tobacco industry will continue to find ways to attract new generations and renormalize tobacco use.  

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