As the global tobacco control debate intensifies, the Coalition of Asia Pacific Tobacco Harm Reduction Advocates (CAPHRA) is sounding the alarm over growing foreign influence in national policymaking. The group claims that powerful external actors—such as Bloomberg Philanthropies—are shaping tobacco harm reduction (THR), with strategies in countries like India, sidelining local experts and evidence.
Moreover, with the COP11 conference approaching, CAPHRA warns that ideological agendas are overshadowing science, endangering both adult smokers seeking safer alternatives and national sovereignty in health policy. As trust erodes, hopes for meaningful change at the event remain dim.
CAPHRA is calling for increased transparency in global tobacco control policies, citing evidence that foreign funding may be shaping domestic regulations across the region. The organization has identified patterns suggesting that Bloomberg Philanthropies has unduly influenced THR policies in countries such as the Philippines, India, Pakistan, Bangladesh, Indonesia, and Vietnam.
Exported Agendas, local consequences
This is not the first time that such concerns have been raised, with Nancy Loucas, CAPHRA’s Executive Coordinator, consistently highlighting that the external funding is prioritizing ideology over science, sidelining regional experts in the policymaking process. In line with pleas by tobacco harm reduction experts worldwide, Loucas insists that national health policies should be developed with input from local stakeholders and based on scientific evidence, rather than being dictated by the interests of foreign entities.
In actual fact, CAPHRA’s concerns extend beyond Asia-Pacific. In February 2025, the organization, along with ARDT Iberoamerica and CASA Africa, formally requested clarification from the UN Special Rapporteur for Harm Reduction regarding biased statements in a report on tobacco harm reduction. Sadly, despite the importance of the inquiry, CAPHRA has received no response, which the group sees as part of a broader pattern of disregarding dissenting viewpoints.
The upcoming COP11 meeting is naturally viewed as a pivotal moment for reinforcing national sovereignty in tobacco control. CAPHRA urges FCTC member states to push back against external pressures and adopt policies grounded in scientific evidence. The group emphasized that countries such as the Philippines, Japan, and New Zealand have successfully balanced public health protection with harm reduction strategies through progressive regulations on non-combustible nicotine products.
CAPHRA is urging member states to critically examine the sources of policy guidance and prioritize comprehensive, evidence-based approaches that acknowledge harm reduction as a crucial component of tobacco control. The organization argues that global public health institutions must uphold their core mission of promoting policies rooted in scientific evidence rather than ideological agendas.
The global tug-of-war over nicotine policy
Sadly however, experts in the field do not hold high hopes for the conference which will be held between the 17th and the 22nd November 2025.The FCTC COP is renowned for the fact that discussions are held behind closed doors, often excluding critical voices—most notably consumers and harm reduction advocates. This lack of transparency fosters an echo chamber where dissenting views are suppressed and consensus is shaped more by ideology than evidence. As a result, policies may prioritize prohibitionist approaches while ignoring real-world experiences of former smokers who have successfully quit using safer nicotine products. Excluding these stakeholders undermines the legitimacy and effectiveness of tobacco control strategies, ultimately jeopardizing public health goals.
Meanwhile, Loucas also highlighted the existance of such issues on a local level. Last September she criticized the Public Health Collaboration Council (PHCC.org.nz) for promoting a “covert prohibitionist agenda” in their recent publications. Loucas argued that the PHCC’s portrayal of oral tobacco and nicotine products as gateways to teen addiction ignores their potential as harm reduction tools for adult smokers.
Gateway theory revived?
In fairness, recent findings also dispute the argument that vaping is displacing youth smoking in New Zealand. A new study published in Lancet Regional Health-Western Pacific analyzed 25 years of data (1999–2023) from nearly 700,000 high school students aged 14 to 15 finding that while there has been a significant decline in adolescent smoking rates overall, the study revealed that this decline slowed notably after 2010, coinciding with the rise of e-cigarettes. If smoking rates had continued their pre-2010 downward trend, fewer adolescents would have ever smoked or become regular smokers by 2023.
The research team wrote that by 2023, 12.6% of 14- and 15-year-olds reported having tried smoking at least once. However, had smoking rates continued to fall at their pre-vaping pace, that figure would have been 6.6%. Similarly, 3% of students reported smoking regularly in 2023, but this rate would have been 1.8% without the influence of vaping.
However, some tobacco harm reduction advocates have critiqued the study. They highlighted that the research does not adequately account for other factors influencing smoking trends, such as socioeconomic variables and broader public health initiatives. These experts contend that vaping serves as a harm reduction tool for adult smokers and that its role among adolescents requires nuanced understanding.
In contrast, organizations like the Public Health Collaboration Council (PHCC) have called for urgent government action in response to the study’s findings, highlighting the need for stricter regulations to prevent youth vaping and smoking. phcc.org.nz. This is not surprising given that as Loucas highlighted, the PHCC is known for adopting a prohibitionist ideology, which she describes as “philanthropic colonialism.” This approach, she contends, imposes Western-centric health policies without considering local contexts or scientific evidence, thereby hindering effective public health strategies.
Colonizing Public Health?
In fact, last September Loucas also expressed concern about PHCC’s alignment with the World Health Organization (WHO), suggesting that it compromises scientific integrity. She argued that policy alignment with WHO should be based on the latest research rather than seeking international recognition. CAPHRA has been advocating for a re-evaluation of the PHCC’s stance on oral tobacco and nicotine products, calling for balanced policies rooted in scientific evidence.
CAPHRA has called on governments to hold the WHO and the FCTC accountable for excluding consumer perspectives from tobacco control discussions. In their revised report, “The Subversion of Public Health: Consumer Perspectives,” CAPHRA criticizes the WHO and FCTC for overlooking harm reduction strategies, despite these being part of tobacco control under Article 1d of the FCTC.
This exclusion, underlines the report, undermines public health and disregards the experiences of former smokers who have successfully transitioned to safer nicotine products (SNPs) like e-cigarettes and snus. She urged governments to demand the inclusion of consumer insights in policy development, arguing that consumers’ real-world experiences are vital to forming effective tobacco control policies.
The report calls for standardized methods to track SNP usage, comprehensive reviews of all scientific data (both supporting and criticizing SNPs), and active consumer participation in policy discussions. CAPHRA further accuses the WHO and FCTC of cherry-picking evidence, marginalizing consumer voices, and violating ethical principles by excluding those most affected by smoking and SNPs.
The hidden hands behind tobacco control in Asia-Pacific
In conclusion, CAPHRA’s concerns echo those of tobacco harm reduction experts and groups worldwide, highlighting a troubling trend in global tobacco control—one where ideology and foreign interests often take precedence over science, transparency, and the voices of those most affected. As COP11 approaches, the lack of consumer representation and behind-closed-door policymaking foster an environment ripe for groupthink, undermining harm reduction and jeopardizing millions of lives. The call for inclusion, scientific integrity, and respect for national sovereignty is not just timely—it is essential for safeguarding global public health in an increasingly polarized debate.
