The Silencing That Prolongs Combustion
Towards the Eleventh COP: from Precaution to Denial, and Ultimately to the Silencing of Dialogue. How the FCTC Became Impervious to Science, Reality, and Complexity.
The camera switches on, revealing a sober-looking office, lined with shelves of identical volumes, perfectly aligned like soldiers in formation.
He asks for a moment and disappears from the screen. García Márquez, Thomas Goodwin, Nietzsche, an immaculate Milton Friedman — and, disrupting the symmetry, a slightly worn copy of Parade’s End. I hesitate.
As I waver, I consider breaking the ice with a smile, perhaps a comment on literature. But I hadn't come for literary intrigue. I had come for answers: to a question both simple and disconcerting: Why, in the face of scientific progress, technological advances, and the irreversible turning point in tobacco control, does the world’s leading agency on the matter refuse even to consider harm reduction?
Then he returns—abruptly. Back straight, brow faintly furrowed, his face lit by a dim light. In a clipped tone, he tells me I have five minutes. No more. That I should send him an email.
His gaze dismantles my plan. I skip the preambles.
—How and why has the Framework Convention on Tobacco Control become such a sealed-off, almost hermetic institution, so resistant to dissent?
Perhaps now I recall a faint trace of a smile—not in the eyes, only at the corner of the mouth—just before his voice, firm and measured, filled my speakers. He had been in that room before — six COPs, at least. I didn’t need to ask how he knew.
—This isn’t about fortification or cowardice. It’s a conscious, strategic decision. The FCTC has chosen to erect a wall of… impermeability, as you put it, to shield its directives from external pressures that could compromise their integrity.
—And what are the pillars on which that tactical choice rests?
—First and foremost is the inescapable recognition that the tobacco industry has historically relied on systematic disinformation tactics, and continues to do so through the funding of biased studies, persistent lobbying, and repeated attempts to erode even the most robust scientific evidence. By preemptively rejecting all forms of hidden interest, the Convention defends not just its reputation for rigor, but its very capacity to act independently.
—But doesn’t that risk limiting academic or scientific debate?
—No. Quite the opposite. The FCTC fosters independent research, peer-reviewed studies, conferences, and open forums. Its “impermeability” functions only as a filter, excluding actors with clear conflicts of interest, particularly the industry’s commercial arms and their astroturfing fronts, whose agendas clash with the ethics of public health.
—So this impermeability… It’s a defensive mechanism?
For a moment, I wonder if we’re simply dressing up a lock with sophistication—if there isn’t something paradoxical in defending scientific openness by sealing off the political space. But before I can articulate the thought, he answers—this time in a slightly sharper tone, as if the question were unnecessary. Or naïve.
—Exactly. It’s a containment wall. It blocks lobbying tactics and fallacious arguments from contaminating deliberations. All decisions and amendments are based on studies reviewed by independent committees. Every resolution is grounded in the best available evidence, not in technical opinions disguised as strategy, disguised as technical opinion.
—And what, ultimately, is the primary gain of maintaining this approach?
He doesn’t reply immediately. He looks off-screen, seeking distance, or perhaps refuge, in what remains unseen. When he speaks again, it’s with a steady, almost ceremonial cadence, as if pronouncing a truth that requires no reply.
—By staying shielded, the FCTC protects the most vulnerable and guides effective public policy. It reminds us that when corporate power confronts the common good, science — not diplomacy, not rhetoric — must be the final arbiter.
He pauses. Then leans slightly toward the camera—just a gesture. He asks that I respect his anonymity, not out of fear of contradiction, but of something more challenging to name.
Before disconnecting, he leaves an open-ended phrase:
—If you need more… you know how to find me.
I leave the call with a feeling that escapes definition. There was no rupture, no rejection. However, a warning lingered: in specific spaces, some questions may sound like insubordination, rather than a fair form of defiance.
And yet, what stayed with me wasn’t a refusal, but a veiled certainty — there is more. And that “more” begins to take shape when one starts to examine the terrain in dispute.
The Framework
Since electronic cigarettes and heated tobacco products emerged as technological alternatives over the past decade, the Conference of the Parties to the Framework Convention on Tobacco Control has ceased to be merely a technical forum. It has become the epicenter of an ideological standoff — a minefield where debates are conducted under the shadow of decisions already made.
On one side, distant and often silenced voices of researchers, clinicians, and consumer advocates who see in these devices a tangible opportunity to reduce smoking-related harms, especially for the more than one billion smokers worldwide who, due to structural barriers or entrenched behaviors, will not quit through abstinence alone.
On the other, a policy architecture forged in decades of adversarial struggle against the tobacco industry, which has grown increasingly strident — hostile not only to the industry, but to any form of innovation that so much as evokes its silhouette. Even when the potential public health benefits are supported by peer-reviewed data and positive outcomes from countries like the United Kingdom, Japan, Sweden, and New Zealand, the COP’s stance remains unyielding, seemingly indifferent.
It is essential to clarify: the COP is not the WHO itself, but a political body composed of the 183 signatory countries to the FCTC. The WHO serves as the Convention Secretariat — offering ambiance, technical advice, and evidence reviews — but it is the member states, through consensus or vote, who define the policy lines.
In addition to national delegations, the COP admits a select group of observers: representatives from civil society organizations and, notably, institutional lobbies such as the Campaign for Tobacco-Free Kids (CTFK), whose presence shapes the discursive and normative contours of the Convention. These actors, though officially external, often exert influence over the framing of risk, legitimacy, and acceptable debate. And increasingly, those lines reflect not just caution, but resistance — a resistance that hardens when confronted with alternatives outside the prevailing orthodoxy.
So the question that hovers, suspended and unresolved, is disarmingly simple:
Why, in the face of mounting empirical evidence and persistent illness and death, has the COP never considered — not even as a hypothesis — a more pragmatic, harm-reduction–oriented path?
That should have been the question.
The Convention's Siege: How the COP-FCTC Shut the Door on Harm Reduction
Over nearly two decades, in the austere and almost antiseptic corridors of the Conferences of the Parties (COP) to the Framework Convention on Tobacco Control (FCTC), a posture crystallized — one that rejected more than it welcomed, excluded more than it integrated.
What emerged —under the legitimate but increasingly rigid pretext of shielding public policy from the interests of the tobacco industry— was an architecture of distrust: a kind of regulatory fortress where anything new is, by definition, suspect.
Inside those walls, harm reduction ceased to be a public health strategy and became, in the eyes of the Convention, an allegory of the enemy.
What began as a justified attempt to regulate an industry with a long record of insidious tactics gradually hardened into a doctrine: one impermeable to ambivalence, resistant to nuance, and hostile to complexity.
In this new framework, risk reduction—far from being welcomed as an emerging public health paradigm—was denounced as a strategic disguise: a Trojan horse through which Big Tobacco (the Evil) might reenter through the flanks of (the Holy) health policy.
At this point, the trajectory becomes revealing. In the early sessions of the Conference of the Parties, between 2006 and 2010, the so-called “new products” were approached with a mix of technical curiosity and cautious detachment, like someone examining the unfamiliar, but not yet condemning it.
COP4, held in my neighboring Punta del Este in 2010, did not legislate, prohibit, or declare — it merely requested reports on national regulatory experiences with electronic nicotine delivery systems (ENDS) and non-combustible tobacco products. There was no rush to judgment, no prohibitionist haste.
But by 2014, during COP6 in Moscow, a shift had begun to take form. For the first time, the WHO report mentioned the need to “minimize potential risks” associated with ENDS—a formulation that, though cautious, glanced—almost inadvertently—at the vocabulary of harm reduction.
It was as if the supposed scientific language itself hesitated, caught between evidence and institutional fear, whispering the name of a paradigm it dared not pronounce.
COP6 (Moscow, 2014)
COP6 marked the institutional starting point of the FCTC’s formal response to electronic nicotine delivery systems (ENDS). Although it acknowledged the heterogeneity of national approaches—from outright bans to regulation as medicines or consumer products—the decision FCTC/COP6(9) already outlined, with bureaucratic clarity, the four normative pillars that would guide subsequent deliberations:
(a) prevent initiation among non-smokers and youth;
(b) minimize risks to users and bystanders;
(c) suppress unsubstantiated claims of benefit;
(d) shield public policies from the commercial interests of the industry.
It was at once a blueprint of precaution and a perimeter of containment. The vocabulary of doubt was beginning to ossify into doctrine.
But that window of ambiguity would prove brief — almost a bureaucratic slip, quickly sealed. Beginning with COP7, held in 2016 in Delhi, the dominant narrative shed even the illusion of nuance. The very notion of “reduced harm” was no longer tolerated as a scientific proposition, but instead recast as a rhetorical trap — a discursive decoy deployed by the industry.
The rupture was explicit. In the official report, the new posture was declared without ambivalence: “Any reduction in the capacity to cause addiction [...] by no means suggests a lower risk to human health.”
It was the birth of a new orthodoxy — not regulatory, but rhetorical.
What could have marked the beginning of a nuanced and differentiated analysis of risk, as public health has long done with sterile syringes, methadone, or condoms, was swiftly replaced by a binary and moralizing logic: total abstinence or tacit complicity.
In this new framing, merely entertaining the possibility of less harmful alternatives was enough to invite suspicion. Complexity gave way to conviction; a doctrine of intention displaced the pragmatism of public health.
COP7 (Delhi, 2016)
With decision FCTC/COP7(9), the Conference intensified its restrictive posture, recommending that countries evaluate the prohibition or stringent regulation of ENDS and ENNDS — even within a context still marked by limited, fragmented, and inconclusive scientific evidence.
The call to develop laboratory methods for measuring emissions was reiterated, but the center of gravity had shifted decisively: the focus now lay on market containment and the fortification of a risk-centric narrative, with scant — if any — consideration for the potential of harm substitution.
Within this reframing, science no longer functioned as a space for exploring alternatives, but as a tool for sanctioning the veto.
COP8, held in 2018 in Geneva, consolidated what had already begun to emerge as a form of epistemological closure. It was during this session that heated tobacco products (HTPs) were officially recognized as stricto sensu tobacco products, and their emissions — despite resulting from heating rather than combustion — were classified as “tobacco smoke.”
The decision, far from being a mere semantic nuance, had direct and far-reaching regulatory consequences. By redefining what is meant by “smoke”, the COP paved the way to apply the same legal framework to HTPs (and ENDS) as to combustible cigarettes.
It was not a technical classification — it was a political decision about how to name risk. (Heated tobacco produces an aerosol at lower temperatures, distinct chemically and physically from cigarette smoke. This heating causes distillation, evaporation, and low-energy pyrolysis of tobacco constituents into an aerosol form.)
Language, at this point, ceased to describe and began to govern.
Institutional vocabulary became an instrument of regulatory power.
Taxonomy turned political.
By reclassifying the aerosols generated by HTPs as “tobacco smoke,” the COP did more than reinterpret an emission or a scientific distinction — it effectively erased the epistemological and public health relevance of risk differentiation.
With a single terminological maneuver, it rendered equivalent what remains, in both chemical composition and epidemiological profile, fundamentally different.
It was not a clarification — it was a preemptive veto. A discursive lockdown.
COP8 (Geneva, 2018)
It was during this session that heated tobacco products (HTPs) rose decisively to the center of regulatory concern. Decisions COP8(21) and COP8(22) not only formally codified HTPs as stricto sensu tobacco products, but also warned of their increasing promotion as “clean alternatives” — a promise which, according to the COP, still lacked conclusive evidence.
Comprehensive reports were commissioned on toxicity, appeal, cessation potential, and their policy impact. But even this technical gesture — the call for more data — bore the imprint of structural skepticism: the subtext already suggested that no amount of evidence would ever suffice.
Perhaps the most emblematic document, however, emerged at COP9, in 2021, when the FCTC/WHO declared that heated tobacco products had been introduced with “unproven claims of ‘reduced harm,’” and, immediately afterward, emphatically reaffirmed that “reduced exposure does not necessarily mean reduced harm.”
The formulation, though technically accurate, functioned as more than a scientific caveat: it became a doctrinal assertion. It was the language of veto draped in prudence. The acknowledgment that “less” is not the same as “none” was now used to imply that “less” is not different enough either.
Language, which once hesitated, now spoke with certainty. The full conversion of institutional rhetoric into dogma.
It is at this point that official discourse ceases to operate as scientific caution and begins to assume the contours of dogma. By delegitimizing the fundamental distinction between combustion and heating, between smoke and vapor, the COP was not merely dismissing a physico-chemical fact — it was erasing the lived experience of countries like the United Kingdom, Sweden, or Japan, where the substitution of cigarettes by lower-risk alternatives has led to concrete, measurable epidemiological benefits.
No matter how much evidence accumulates, it crashes against a wall of institutional deafness: what contradicts the prevailing narrative is simply not permitted to pass through. At this stage, the rhetoric of the COP is no longer merely restrictive — it becomes impermeable, hermetic, indifferent to the empirical world.
COP9 (Geneva, 2021)
The 2021 documents mark a particularly revealing turning point. In response to decision COP8(22), COP9 endorsed WHO reports that categorically rejected the use of heated tobacco products as a cessation strategy. The core arguments remained unchanged: the absence of conclusive evidence on risk reduction, the persistence of dual use, and the fear of a potential renormalization of tobacco.
From this diagnosis, emerged a set of firm recommendations:
Treat HTPs as equivalent to combustible cigarettes in taxation, health warnings, marketing bans, and inclusion in smoke-free legislation.
Classify HTP aerosols as “tobacco smoke,” even in the absence of combustion, based on the presence of aldehydes and pyrolysis byproducts—a chemical equivalence that ignores context, exposure levels, and modes of use.
Exclude HTPs from any harm reduction strategy under Article 14, thereby preemptively delegitimizing their use as lower-risk alternatives.
What was institutionalized here was not precaution, but refusal in advance: a prohibition of possibility before investigation.
More than a technical dispute, what unfolds is a collision between possible worlds. The harm reduction paradigm — enshrined in public policies on drug use, HIV, and mental health — is grounded in a basic recognition: that people, especially the most vulnerable, will not always be able or willing to abstain completely.
Offering safer alternatives is not condescension — it is a radical act of care.
And it is precisely here that the COP-FCTC, in an unsettling and ironic twist, begins to drift away from its own preamble — the one that calls for “effective, evidence-based measures to reduce tobacco consumption and exposure to smoke.”
When orthodoxy ignores lived experience, it no longer speaks the language of science — but that of regulatory faith.
In practice, the COP has chosen not merely to overlook — but to suppress — any public policy that dares to engage with such nuances.
At COP10 (2023/2024), under the rhetorical mantle of “youth protection,” it was reiterated that new products should be regulated with the same rigor as conventional cigarettes, and that the goal must remain total abstinence — even if that means abandoning millions of adult smokers to their fate, without access to viable, lower-risk alternatives.
In this formulation, such zeal seems reserved only for ideal bodies. The real ones — complex, fragile, contradictory — are left outside the equation, even when there is empirical evidence that another approach is not only possible, but already in motion.
In the United Kingdom, for instance, e-cigarettes are officially integrated into the NHS’s cessation strategy. In Sweden, the widespread use of snus has contributed to the lowest rate of lung cancer in Europe.
Far from being outliers, these cases are treated by the COP not as policy signals, but as aberrations — when, in fact, they could be evidence that another public health pathway is not only viable, but already mapped.
The Panama Declaration (COP10, 2023/2024): Ideological Shielding and a Closed Door?
The final declaration of COP10 amplifies the pattern of systematic antagonism toward any emerging nicotine product by reiterating — without nuance or empirical distinction — the collective risk ascribed to all novel alternatives.
Under the pretext of protecting public health, the declaration reaffirms the invocation of the human rights framework as a normative shield for what are, in essence, prohibitionist policies — a paradox as unsettling as it is revealing.
By explicitly rejecting any possibility of regulated coexistence with alternative nicotine delivery systems, the COP does more than close the door on debate — it bars reality itself from entering.
The Architecture of Institutional Dogma
The COP’s approach over the last four conferences reveals more than caution: it signals the consolidation of a structural pattern of rejection. A systematic refusal of any alternative to cigarettes that does not involve total nicotine abstinence — as if the only legitimate path to protection were absolute denial.
This position rests on three central pillars:
Conceptual conflation between industry and innovation: By automatically rejecting any product semantically associated with the tobacco industry, the COP disregards international experiences where strict regulation and critical oversight coexist with harm reduction strategies that, in practice, save lives.
Denial of the risk hierarchy: Despite numerous studies showing that products like snus, ENDS, and HTPs carry significantly lower health risks than combustible cigarettes, the FCTC continues to treat them as equivalent — a conflation that defies both scientific evidence and common sense.
Hostility toward user agency: Adults who have successfully transitioned to lower-risk alternatives are absent from official discourse. Their voices are silenced under a narrative of “protection” that, in practice, neglects autonomy, pragmatism, and the ethical right to choose.
And then there is the epistemological dimension — perhaps the most disquieting of all. The COP rightly notes that much of the research supporting harm reduction is funded by the tobacco industry. That, in part, is true.
But what remains unsaid is that the imbalance stems not only from industry proximity, but from the deliberate absence of alternatives: a desert of public funding, and the systematic exclusion of independent scientific voices within the FCTC’s own spaces. The result is a feedback loop that reproduces the very asymmetry it claims to reject.
By banning dissent, the COP does not protect science — it isolates it, impoverishes it, and converts it into a closed circuit of confirmation.
By excluding stakeholders — including consumer organizations, journalists, and public officials—from observer status, the COP does not merely restrict access: it suppresses contradiction.
And in doing so, it abdicates science as a space of epistemic confrontation, retreating instead into a logic of internal validation — a confirmation committee that decides before listening.
Yes, even if my source might argue otherwise, the FCTC functions as a structure estranged from the dialogical principle of science, operating instead as a self-referential system of validation.
But perhaps the most tragic consequence is this: such a stance does not neutralize the industry. It merely offers it, on a silver platter, the unregulated channels of communication with users, who then cease to be citizens and become consumers.
The COP claims to defend science and protect youth. But its systematic refusal to consider harm reduction as a legitimate public health strategy ends up — ironically — perpetuating the very thing it seeks to eliminate: combustion.
By turning risk into an indivisible, undifferentiated category, it obscures the nuances that could save lives — not in some idealized future, but now, among the bodies that still breathe.
The Urgency of a New Epistemological Contract
If the mission of the FCTC and WHO is indeed to reduce the deaths and diseases caused by smoking, then the systematic obstruction of lower-risk alternatives is not simply a technical miscalculation — it is an ethical failure.
The science of harm reduction, already consolidated in other public health domains, can no longer be marginalized by ideological stances masked as prudence. Protecting public health is not about denying reality — but about confronting it with tools that blend regulatory rigor, ethical clarity, and a radical fidelity to evidence — even when that evidence challenges our assumptions, and our convictions along with them.
The challenge of the coming decade, then, will be to move from denial to the regulated integration of lower-risk nicotine products, with public policies that shift from chasing abstract ideals to responding to the urgent, embodied needs of real populations.
Because it is they — with their imperfect bodies, persistent habits, and contradictory desires — who remain exposed to avoidable risks. And it is for them — not for a principle, nor a posture — that public health policy must exist.
Tobacco use continues to kill more than 8 million people every year worldwide. No other preventable behavior causes such devastation, and yet we persist in treating those deaths as statistical residue.
In the face of this, the question the COP avoids — but that more and more smokers, clinicians, and researchers are beginning to ask — feels disarmingly simple:
What if it’s not about defeating the industry, but about protecting those who smoke?
As long as silence is the answer, combustion will continue to prevail.
The next Conference of the Parties, COP11, will take place from November 17 to 22, 2025, in Geneva.
