COP11 and the promise of harm reduction – Part 1

What is COP11?

Later this year (17–22 November 2025) the Conference of the Parties to the WHO Framework Convention on Tobacco Control (COP11) will convene in Geneva. The COP is the governing body of the WHO Framework Convention on Tobacco Control (FCTC), a global treaty that came into force in 2005 to address the health, social and economic harms caused by smoking and other tobacco use. The FCTC’s own text recognises that “tobacco control” means a range of supply, demand and harm reduction strategies that aim to improve population health by reducing people’s consumption of tobacco products and exposure to tobacco smoke. It also celebrates the role of nongovernmental organisations and consumer groups in tobacco control.

COP11 should therefore be an opportunity to discuss the full spectrum of tobacco‑control policies, including the evidence that safer nicotine products help smokers quit. Instead, the provisional agenda released by the FCTC secretariat paints a very different picture. Under agenda item 4.5 the Secretariat proposes that parties discuss “implementation of measures to prevent and reduce tobacco consumption, nicotine addiction and exposure to tobacco smoke, and the protection of such measures from commercial and other vested interests of the tobacco industry in light of the tobacco industry’s narrative on ‘harm reduction’”. In other words, harm reduction is framed as a narrative of the tobacco industry rather than a legitimate public‑health strategy. The legal basis cited for the discussion—Articles 5.2(b) and 5.3—focus on government structures and protection from industry interference. The agenda does not reference Article 1(d), even though the definition of tobacco control in that article clearly includes harm‑reduction strategies.

Why harm reduction matters

For millions of adult smokers, the reality is not between smoking and abstinence but between continuing to inhale burning tobacco and switching to products that deliver nicotine without smoke. Mainstream health agencies are now clear that such products drastically reduce harm:

• Royal College of Physicians (RCP) – The RCP’s Nicotine without Smoke report concluded that e‑cigarettes and other non‑combustible nicotine products are “unlikely to exceed 5 % of the harm from smoking” and have the potential to prevent almost all the harm from tobacco use. It recommended that regulation should not inhibit the development and use of safer nicotine products and that promoting such products could benefit public health.
• UK National Health Service (NHS) – The NHS states that nicotine vaping is far less harmful than smoking and is one of the most effective tools for quitting. Experts reviewing the evidence in 2022 concluded that vaping poses “a small fraction of the risks of smoking”.
• Cancer Research UK – The charity notes that e‑cigarettes do not contain tobacco and therefore lack most of the harmful chemicals in cigarettes; switching to vaping reduces exposure to carcinogens, and there is no good evidence that second‑hand vapour is harmful. Nicotine itself does not cause cancer.
• Public Health England (PHE) – A 2015 evidence review for the UK government concluded that e‑cigarettes are around 95 % less harmful than smoking and help smokers quit; there was no evidence that vaping acts as a gateway into smoking.

These conclusions are not restricted to the UK. Countries that have embraced accessible harm‑reduction products are seeing dramatic declines in smoking:

• New Zealand has implemented regulated access to vaping products while pursuing a goal of a “Smokefree Aotearoa”. Official statistics show that by 2023/24 only 6.9 % of adults were daily smokers, down from 20 % in 2011/12. Daily smoking among women was 5.8 % and 8.1 % among men.
• Sweden allows the sale of snus and nicotine pouches, and the country now has one of the lowest smoking rates in the world. In 2024, only 5.4 % of the population smoked daily, and when immigrants are excluded, the rate is 4.5 %. Consequently, Sweden has much lower tobacco‑related mortality than other EU countries.
• United Kingdom – The Office for National Statistics reports that in 2023 about 6 million adults (11.9 %) smoked cigarettes, the lowest proportion since records began, while 5.1 million adults (9.8 %) used e‑cigarettes. Among 16‑ to 24‑year‑olds, e‑cigarette use is 15.8 %. The UK is on course to achieve a smokefree target (≤5 %) by 2030.

These data show that harm‑reduction products are not fringe novelties; they are mainstream tools that help millions of people avoid the dangers of combustible tobacco. When regulated responsibly, they accelerate declines in smoking and save lives. Ignoring or delegitimising harm reduction in COP discussions risks leaving smokers with only the most dangerous option, continued smoking.

Looking ahead

COP11’s provisional agenda frames harm reduction as a tobacco‑industry narrative and avoids referencing the article of the FCTC that recognises harm reduction. For a treaty that claims to be evidence‑based, this sends the wrong signal. Public‑health advocates, consumer groups and the thousands of people who have used safer nicotine products to quit smoking deserve a seat at the table. Harm reduction is not an industry ploy; it is a public‑health strategy that saves lives.

In the next article we will examine how the FCTC’s closed‑door approach at COP11 excludes those very people whose lives are most affected by tobacco‑control policies.