
The Framework Convention on Tobacco Control (FCTC), adopted by the World Health Organisation (WHO) in 2003, is often celebrated as the world’s first global public health treaty to reduce tobacco consumption and its associated harm. At its core, the treaty is supposed to protect public health, regulate the tobacco industry, and curb the devastating effects of smoking worldwide. While the FCTC has drawn attention to the tobacco epidemic and prompted policy action in some countries, a closer examination reveals significant flaws. The FCTC’s approach is often misleading, ineffective, and ideological, undermining its credibility and doing more harm than good.
A Monumental Failure of Implementation: Empty Promises and Minimal Progress
The FCTC presents itself as a comprehensive plan for global tobacco control, but its impact has been limited. The treaty urges countries to adopt evidence-based measures—such as raising tobacco taxes, implementing public smoking bans, and introducing graphic health warnings on packaging—but many signatories fail to implement these commitments.
China, for example, produces and consumes more tobacco than any other country in the world, and smoking rates remain alarmingly high. Despite signing the FCTC, China has made little real progress, continuing to permit widespread tobacco advertising and neglecting to enforce meaningful smoking bans. While countries like the UK and Australia have introduced tough anti-smoking laws, these examples remain exceptions. Globally, the treaty lacks enforcement mechanisms, allowing nations to publicly endorse the FCTC while ignoring its provisions behind the scenes.
In stark contrast, Sweden is a success story by embracing harm reduction rather than rigid adherence to FCTC ideals. By promoting smokeless alternatives such as snus—a form of oral tobacco that is significantly less harmful than smoking—Sweden has achieved the lowest smoking rates in the world. Less than 5% of Swedish adults now smoke and have become “smoke-free”—a milestone the FCTC claims to aim for but fails to deliver globally. Sweden proves that pragmatic, science-based policies focused on harm reduction work far better than rigid, prohibitionist strategies.
Harm Reduction and Vaping: Ignoring Science-Based Solutions
One of the FCTC’s most glaring failures is its rejection of harm reduction strategies, including vaping, smokeless tobacco, and other alternatives. While the treaty maintains an absolutist focus on total cessation, it disregards mounting evidence that products like e-cigarettes, nicotine pouches, and heated tobacco devices are far less harmful than smoking traditional cigarettes.
In the UK, public health authorities have embraced vaping as a harm-reduction tool. As a result, smoking rates in the UK have fallen significantly, with many smokers successfully switching to vaping.
Similarly, New Zealand has emerged as a leader in innovative tobacco control. The government has taken a balanced approach, promoting vaping as a safer alternative for smokers while implementing bold policies, such as their “Smokefree 2025” initiative. The programme aims to eliminate smoking by focusing on harm reduction, restricting the sale of traditional cigarettes, and encouraging smokers to switch to vaping or other safer nicotine products. New Zealand’s pragmatic, evidence-based strategy has already led to significant declines in smoking rates and provides a clear model for other nations.
In contrast, the FCTC continues to discourage vaping and other safer products through restrictive policies and blanket bans. These decisions, rooted in outdated ideology rather than science, deny smokers access to life-saving alternatives and keep millions trapped in their addiction to combustible tobacco.
The Maldives has recently banned vaping despite the high smoking rates among its population. This decision highlights the flaw of adopting prohibitionist policies without providing viable alternatives to reduce harm. Instead of embracing scientifically backed harm reduction strategies like vaping, which have proven effective in other countries, the Maldives risks prolonging the smoking epidemic by restricting access to less harmful alternatives. This contradiction underscores the FCTC’s failure to adapt to the evolving landscape of tobacco control.

Sweden and New Zealand demonstrate that embracing harm reduction strategies—rather than dismissing them—can drastically reduce smoking rates and save lives. If the FCTC were serious about achieving a “smoke-free world,” it would promote these evidence-based approaches rather than undermining them.
The Limits of Article 5.3
Article 5.3 of the FCTC specifically calls for governments to protect public health policies from industry interference. It states that “effective measures” should be taken to prevent industry influence over the formulation and implementation of tobacco control policies. In principle, this provision is a crucial safeguard against the longstanding ability of the tobacco sector to shape policies in its favour.
In practice, however, Article 5.3 has proven largely ineffective. Despite its clear intent, the tobacco industry's influence continues to be felt in policymaking across many regions. Lobbying, public relations campaigns, and other forms of influence remain powerful tools that shape regulatory frameworks to favour economic interests, often at the expense of public health goals.
Governments, especially in countries where the tobacco industry is a significant economic force, have been slow to enforce the protections of Article 5.3. In these countries, political and economic dependencies, such as tobacco-related tax revenues or jobs tied to tobacco production, frequently result in policies that prioritize the industry's interests rather than public health. This failure to implement effective safeguards undermines the FCTC’s mission of reducing tobacco-related harm.
Economic Dependencies and Industry Influence
The challenges in enforcing Article 5.3 reflect a broader issue within global tobacco control efforts: economic dependencies on the tobacco sector. In many countries, tobacco-related revenues, including taxes and employment, play a significant economic role. These financial ties often create a conflict of interest, where governments are reluctant to adopt measures that could harm the industry, even if those measures would benefit public health.
This dynamic allows industry interests to exert significant influence on policy decisions, weakening the effectiveness of tobacco control measures. As a result, policies designed to reduce smoking and protect public health are often compromised or diluted.
Reconciling Article 5.3 with Harm Reduction
The principles of Article 5.3 and harm reduction are not inherently at odds. A balanced approach can protect public health policies from undue industry influence while leveraging the potential of smoke-free products to reduce harm.
1. Regulation, Not Exclusion
Governments should regulate smoke-free products independently and transparently, ensuring public health benefits are maximised without granting the industry undue influence.
Standards for product safety, marketing restrictions, and age-verification measures can prevent misuse and ensure alignment with harm reduction goals.
2. Transparency in Industry Engagement
Clear conflict-of-interest policies can enable evidence-based discussions about harm reduction without compromising the integrity of public health policymaking.
3. Strengthening Safeguards
Empower civil society and independent experts to monitor industry actions, ensuring compliance with Article 5.3 while promoting harm reduction strategies.
A Disregard for Economic Realities in Developing Nations
The FCTC’s strict tobacco control measures often overlook the economic realities faced by developing nations. Tobacco farming remains a vital source of income for millions of farmers in low-income countries, yet the treaty offers few practical solutions to help these individuals transition to alternative livelihoods.
In addition, the FCTC’s failure to embrace harm reduction has economic consequences. By dismissing vaping and other safer products, the treaty deprives smokers in low- and middle-income countries of affordable alternatives that could reduce health costs and premature deaths. Instead, policies like blanket bans and punitive taxes disproportionately harm the poor, where smoking is both a cultural norm and an economic reality.
To succeed, tobacco control efforts must account for these disparities, offering targeted solutions that address local contexts rather than imposing a one-size-fits-all model. Countries like New Zealand, for instance, are working to balance public health goals with the realities of socioeconomic disparities through harm reduction.
The Stigma and Harm of Public Health Messaging
The FCTC’s approach to tobacco control often relies on stigmatising smokers, framing smoking as an immoral behaviour rather than a public health issue rooted in addiction. This punitive mindset alienates smokers, creating shame and guilt that make it harder for individuals to seek help or consider safer alternatives like vaping.
Instead of fostering stigma, tobacco control efforts should focus on:
Treating smoking as a health issue, not a moral failure
Promoting vaping, snus, and nicotine pouches as legitimate tools for reducing harm.
Providing non-judgemental support for smokers who struggle to quit.
Both Sweden and New Zealand provide examples of what a compassionate, science-driven approach looks like. By focusing on harm reduction, they have avoided the stigma associated with rigid, abstinence-only messaging, empowering smokers to make healthier choices.
Conclusion:
The FCTC has succeeded in drawing global attention to the tobacco epidemic, but its refusal to evolve with the evidence limits its effectiveness. By ignoring harm reduction strategies like vaping and smokeless tobacco, failing to address economic realities, and perpetuating stigma, the treaty risks prolonging the very crisis it seeks to solve.
A smoke-free future is achievable, but it requires pragmatism, compassion, and a willingness to adapt. By recognising the role of harm reduction, the FCTC has the potential to transform global tobacco control and deliver real, measurable benefits to millions of smokers worldwide. Until then, it will remain an outdated and ineffective framework, disconnected from the realities of addiction and the solutions that could save lives.