The World Conference on Tobacco Control’s Harmful Hypocrisy

In an insightful and quietly devastating editorial in Nicotine & Tobacco Research, Dr. Caitlin Notley of the University of East Anglia offers a first-hand account of the 2025 World Conference on Tobacco Control in Dublin. What she describes is not a celebration of evidence-led progress, but a conference riddled with contradictions, intellectual confusion, and a disturbingly narrow public health mindset.

The event gathered leading figures from around the world, supposedly to share research and strategy on reducing tobacco-related harm. And yet, Dr. Notley’s account reveals a field increasingly paralysed by ideological rigidity, where genuine scientific inquiry is overshadowed by orthodoxy and political theatre. As she notes, “there was a lack of clarity… with regards to definitions, ‘harms’, the ‘endgame’ and also conflicts of interest.” These aren’t minor issues, they go to the very heart of why global tobacco control is failing to grasp opportunities.

At a conference supposedly rooted in public health science, speakers could not even agree on the definition of “harm.” In one session, vaping was accurately presented as a harm reduction tool, particularly beneficial for pregnant women who smoke. In the very same symposium, another speaker called for a crackdown on vaping, labelling it harmful without ever defining the nature or scale of that harm, or comparing it to far greater damage caused by cigarettes. That isn’t science, it is incoherent and confusing.

This disjointed thinking has real-world consequences. If vaping is simultaneously a harm reduction tool and a public health hazard, then guidance given to vulnerable populations will also be ambiguous. People who smoke, especially those facing additional challenges such as homelessness, HIV, or substance dependence, cannot make informed decisions when the experts themselves can’t agree on the nature of safer nicotine alternatives.

Dr. Notley also points out the lack of clarity in what the tobacco control world is actually trying to achieve with its talk of an “endgame.” Some say the goal is a “smokefree” world, where combustible tobacco use is virtually eradicated, while others claim it should be a “nicotine-free” utopia, where even the use of far less harmful products like nicotine pouches, vapes, or medically licensed nicotine replacement therapies are unacceptable. These are drastically different ambitions with completely different implications.

This is the crux of the problem. If the endgame is the total eradication of nicotine, the policy is no longer tobacco control, it is prohibition. That might play well on a conference stage, but it’s completely detached from how people actually quit smoking in the real world. Harm reduction strategies, built around safer nicotine alternatives, have proven effective in countries like the UK, New Zealand and Sweden. Denying that reality not only betrays the science, but it also betrays the people most in need of support.

Dr. Notley doesn’t stop there. She also confronts conflicts of interest, a subject which has become almost an obsession in tobacco control. While the conference proudly excluded any representatives of the tobacco or nicotine industries, it made no serious attempt to interrogate the influence of other funders, including philanthropic organisations with clear ideological missions. When so-called public health professionals are funded by a billionaire committed to nicotine eradication, that’s a conflict of interest. Pretending otherwise is not just misunderstanding the term, it’s dishonest.

This bias, she argues, is often unspoken but ever-present. “Being sceptical and questioning all potential sources of conflicts should be a norm,” she writes. Instead, the conference defaulted to a kind of moral purity test. Industry bad, funders with vested interests good. That isn’t public health, it’s tribalism.

Dr. Notley’s report should be required reading for anyone involved in shaping tobacco policy. It lays bare a harsh truth, that far too many in the global tobacco control field are now more interested in ideological purity than pragmatic progress. And that rigid thinking doesn’t just stifle debate, it risks lives.

As she rightly points out, the most vulnerable (those experiencing poverty, discrimination, and long-term addiction) can only be treated responsibly if the tobacco control industry can agree on what it is trying to do, what constitutes harm, and what success looks like.

The world has the tools to significantly reduce smoking-related deaths in a short space of time, but only if stubborn, ideological merchants of doubt stop treating harm reduction as a threat to be managed and instead embrace it as a core pillar of modern public health.

To do otherwise is not moving forward, instead it simply reinforces a dogmatic and damaging public health echo chamber. That failure to evolve should be shameful to those who claim to be acting in the public’s interest. It is a reprehensible dereliction of duty with real life harmful consequences to people’s lives.

Martin Cullip is International Fellow at The Taxpayers Protection Alliance’s Consumer Center and is based in South London, UK.