12th Global Forum on Nicotine experts fault WHO inaction
Published on: Tue, Jul 22, 2025
By: David Thien Text Size: WARSAW: The World Health Organization (WHO) was taken to task for its refusal to recognise scientific outcomes that prove alternative nicotine products help some 1.3 billion smokers in the world quit the habit, or transition to a less harmful to their health options. This view was shared by many expert participants at the 12th Global Forum on Nicotine (GFN 2025) that was held in Poland at the Warsaw Presidential Hotel from June 19 to 21, 2025. They were scientists and doctors among other professionals. It was reported that smoking causes some 8 million deaths around the world. It is well established that nicotine does not cause smoking-related diseases, which result instead from the inhalation of toxicants in tobacco smoke. High quality independent evidence supporting the role of safer nicotine products in smoking cessation is growing. Vapes, pouches, pasteurised snus and heated tobacco products (HTPs) all deliver nicotine without combustion, leading to substantially reduced health risks in comparison to continued smoking. There was consensus that fear-driven narratives about safer nicotine products means prolonged misery and death for smokers as pervasive misconceptions about safer nicotine products and their role in smoking cessation could see tobacco harm reduction fail to fulfil its huge potential. The Global Forum on Nicotine is organised by Global Forum on Nicotine Limited, an events company committed to providing a platform for global public health debate, knowledge exchange and networking, underpinned by the principles of inclusiveness and multi-sectoral engagement. It does not receive sponsorship from manufacturers, distributors or retailers of nicotine products including pharmaceutical, vaping and tobacco companies. Conference-supporting organisations endorse the event, but have no financial or administrative involvement in organisation of the event. According to Riccardo Polosa, professor of medicine at the University of Catania in Italy, the World Health Organization (WHO) is actively misleading the public about the relative risk of nicotine products compared to cigarettes on purpose. 'They select their references and distort the evidence. There is one single objective, in my opinion, which is to create their own science that supports the abstinence-only narrative,' he says. 'But this has terrible consequences for millions of smokers who would otherwise switch to much less harmful products. In the clinical world, this would be called negligence,' he said, in a special session marked 20 years of the WHO Framework Convention on Tobacco Control (FCTC), in which leading voices examined the treaty's impact. 'The FCTC has succeeded politically and legally,' said Jeannie Cameron, a policy consultant. 'But if we measure success by reductions in smoking and tobacco-related deaths, it has failed.' 'We still have over a billion smokers worldwide. The FCTC was meant to reduce cancer, cardiovascular and respiratory disease,' said Derek Yach, a former WHO director. 'Tobacco harm reduction is the obvious way to stop this crisis in its tracks.' Global experts are tackling a barrier that continues to undermine efforts to reduce the annual 8 million premature deaths related to smoking: misinformation and miscommunication about safer nicotine products and tobacco harm reduction (THR). The GFN 2025 is challenging perceptions as effective communication for tobacco harm reduction conference is a call to action for change. While science increasingly supports safer nicotine products like vapes, snus, pouches and heated tobacco as tools to help smokers switch away from combustibles, fear-driven narratives continue to dominate media and policy. In a keynote lecture Jacob Grier, a journalist covering tobacco policy who has written for Slate and The Atlantic, talked about the disconnect between the evidence for tobacco harm reduction – utility of products like vapes and snus as safer alternatives to continued smoking – and the fact that hostile media narratives are shaping public opinion and health policies. How can impactful, evidence-based messaging be built that respects both reduced-risk products and consumer autonomy? 'Obviously we need to emphasize credible research. The bad news is that having the facts on our side is clearly not enough,' Grier said. 'Journalists seek novelty, so if something isn't new, it isn't news. Millions of people dying from smoking isn't a story, but a few dozen people dying from adulterated [THC or cannabis] vapes generates months of media coverage.' The Global Forum on Nicotine is the only global event that welcomes all stakeholders involved with new and safer nicotine products, including: consumers and consumer advocates; public health experts; policy analysts, parliamentarians and government officials; academics and researchers; product manufacturers and distributors; and media representatives.
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Childhood obesity in Malaysia has been on a steady rise over the past 15 years, with over 30 percent of children aged five to 17 classified as overweight or obese in 2022. (Under the United Nations Convention on the Rights of the Child and Malaysia's Child Act 2001, a child is defined as anyone under the age of 18.) Meanwhile, a study titled 'Prevalence of Childhood Overweight and Obesity in Malaysia: A Systematic Review and Meta-analysis' published in November 2024, found that the prevalence of childhood overweight, obesity and excess weight in Malaysia almost doubled over a 26-year period from 1996 to 2022. According to WHO, in 2022, 37 million children under the age of five were overweight; and over 390 million children and adolescents aged five to 19 years were overweight, including 160 million who were living with obesity. Overweight is a condition of excessive fat deposits in the body, while obesity is a chronic complex disease defined by excessive fat deposits that can impair health. Obesity can lead to increased risk of type 2 diabetes and heart disease. It can also affect bone health and reproduction, and increase the risk of certain cancers. Obesity influences the quality of living, such as sleeping or moving. The diagnosis of overweight and obesity is made by measuring people's weight and height and by calculating the body mass index (BMI): weight (kg)/height² (m²). The body mass index is a surrogate marker of fatness and additional measurements, such as waist circumference, can help the diagnosis of obesity. The BMI categories for defining obesity vary by age and gender in infants, children and adolescents. Struggles of teenager In 2021, when Mikhael was 11 years old and weighed 70 kg, he was offered the opportunity to participate in a study conducted by paediatric specialists at Universiti Malaya Medical Centre (UMMC) to address his obesity issue. His parents were informed that as part of the study, Mikhael had a 50 percent chance of receiving either an actual weight loss medication or a placebo. Wanting to help their only child shed his excess weight, Mikhael's parents agreed to let him join the study. Over the course of the four-year programme, Mikhael received injection-based treatment. But by the time the programme ended, his weight did not decrease. Instead, it continued to rise, reaching 103 kg by early Ramadan (March) this year. (It was later confirmed that Mikhael had been placed in the placebo group, meaning he did not receive the actual medication throughout the study period. This explained why there was no significant change in his weight despite the structured programme). This concerned his parents, prompting them to refer Mikhael back to the Paediatric Obesity Clinic at UMMC, which has been operating since 2006, for further treatment in hopes that he could eventually reach a healthy weight of around 65 to 70 kg. Starting in April, Mikhael has been advised to take an oral medication, Metformin 500 mg, once daily, and after two weeks, two pills per day to help improve insulin efficiency. He is also required to meet with a doctor every three months for follow-up treatments. Meanwhile, his father Mohd Yuzaini Abu Bakar, 48, who resides with his family in Taman Medan in Petaling Jaya, Selangor, said Mikhael had been cute and chubby since infancy. He said Mikhael loved milk and could finish eight big bottles of formula milk per day until the age of three. Mohd Yuzaini, a medical laboratory technologist at UMMC, said he and his wife began consulting a paediatrician when their son was four years old due to concerns about his rapid weight gain. 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His mother would usually pack lunch for him with extra portions, just in case he got hungry later. 'At the tahfiz school, food is also provided, and it's common for people to donate meals there. After school ends at around 7 pm, we would all have dinner together,' he said, adding snacks like biscuits and chocolates as well as bread, fruits and instant noodles were readily available at home in case Mikhael got hungry at night. According to WHO, in 2022, 37 million children under the age of five were overweight; and over 390 million children and adolescents aged five to 19 years were overweight, including 160 million who were living with obesity. — Reuters file pic Hidden genetic risks Sharing that Mikhael's obesity is likely not solely due to his diet, Mohd Yuzaini said it may be influenced by genetic factors although no medical tests have been carried out to confirm this. 'Many members of my family, including me, have obesity issues,' he said, adding his weight once peaked at 165 kg (his height is 176 cm). 'In the past, I used to be active in rugby. When we're involved in sports, we eat and stay active, so we are able to keep our weight under control. But later on, I stopped playing rugby and focused on my job… I became physically less active and started to gain weight.' Mohd Yuzaini, who has six siblings and is the eldest, said his immediate younger sibling passed away due to heart disease caused by obesity. 'Another two siblings are also obese, with one of them having had a leg amputated due to diabetes,' he said, adding that in 2007, he decided to undergo bariatric surgery after his doctor warned he would eventually develop diabetes, hypertension and heart disease if he did not undergo the procedure. Mohd Yuzaini experienced weight loss after the surgery and two years later, his weight dropped to 107 kg from 165 kg. 'Since then, I've been maintaining my weight and if it increases, it's only slightly. Thankfully, my previous borderline blood pressure (readings) and sugar levels have stabilised,' he said. Commenting on the treatment Mikhael is currently receiving, Mohd Yuzaini said it combines the expertise of three clinics – paediatrics, sports medicine and dietetics – and is administered by the Paediatric Obesity Clinic at UMMC. Doctors at the sports medicine clinic gave several exercise recommendations for Mikhael, such as walking up and down the stairs for 30 minutes daily and using a portable pedal exerciser that can be used anytime and anywhere. Said his father: 'We tried it (exercises) during the fasting month (this year) and, thankfully, after the festive season, we saw his weight drop by three kg. 'We'll continue with the suggested approach, combining (intermittent) fasting with exercise… we're aiming for Mikhael's weight to drop to 90 kg by the end of this year.' FAMILY DIET CHANGES Mohd Yuzaini said he and his wife Zaliza Mat Som, 58, have also started controlling their son's diet. 'We've implemented a kind of intermittent fasting for him… he skips breakfast as advised by the doctor and he is allowed to eat during break time at school. 'For his lunch and dinner, we've reduced his portions – he is allowed just a fistful of rice (low glycemic index). We've also cut down on oily and fatty foods, while adding more vegetables and fruits (to his diet),' he added, stressing that dieting is important because Mikhael's current weight puts him at risk for prediabetes. Mohd Yuzaini also said that through changes in his family's eating patterns and by exercising regularly, even his wife has experienced weight loss. 'We want to support Mikhael in achieving his ideal weight, so we too have to make changes towards a healthier lifestyle,' he said. Mohd Yuzaini, meanwhile, suggested that health programmes involving nutritionists, fitness trainers and counsellors be conducted more frequently in schools for students as well as their parents, so they are better informed on how to tackle obesity while also raising awareness about obesity-related diseases. 'Parents should also be informed of their children's (physical) condition, especially when their schools conduct certain tests like the 'Ujian Standard Kecergasan Fizikal Kebangsaan Untuk Murid Sekolah Malaysia' (SEGAK), which can indirectly help prevent obesity among students,' he added. SEGAK is a mandatory physical fitness test conducted twice a year in all government schools in Malaysia, designed to measure students' physical fitness levels based on health indicators. Parents must lead While Mikhael's family is doing their part, experts say the real change must start at home – and with consistent parental support. Sharing his views, fitness coach Kevin Zahri, popularly known as 'Cikgu Fitness Malaysia', said parents must become role models for their children, not just in terms of behaviour but also lifestyle, personal health and nutrition, and should always practice the principles of 'lead by example' and 'walk the talk'. According to him, being overweight or obese at a young age not only affects physical health but can also impact a child's emotions, self-confidence and mental well-being. 'A sedentary and inactive lifestyle is easily carried over into adulthood and difficult to change. Therefore, parents need to help children set boundaries for screen time and video games, and ensure that they are consistently involved in physical activities. 'Physical activity or recreational time should not be treated as a 'special occasion' but rather made part of a child's daily routine to nurture their mental, emotional and physical development from an early age,' he said. Touching on his '30-Day Health Challenge' online programme, held monthly throughout the year, Kevin said the response has been very encouraging, with many families participating to support children who struggle with excess weight and obesity. 'Many parents initially wanted to enrol only their overweight children in the programme, but I encouraged them to join as a family. This is to prevent the child from feeling ashamed, stressed or having low self-esteem. 'It turned out that my approach not only makes the programme more enjoyable for the whole family but they also get to lead a healthier lifestyle. With the 'fit family' concept, it becomes more meaningful as they spend quality time together and support each other,' he said, adding parents should not rely solely on doctors or schools to look into their children's health. Kevin added that while supplements can be used, for example by athletes or to make up for certain nutrient deficiencies, they are not a substitute for real food because what is more important is making healthy food choices to maintain good health. 'My daughter is a national tennis player, while my son goes for football training four times a week. They both take supplements, including multivitamins, to support their growth and cover any nutritional gap. 'As parents, we must take responsibility in leading our own 'circle of influence', which is our family. Start small, like doing physical activities together every Saturday, such as walking, playing badminton or pickleball,' he said, adding that more information about his programme is available at In conclusion, Mikhael's experience underscores the complex web of factors that contribute to childhood obesity – from possible genetic predisposition and family lifestyle to eating habits and emotional influences. His journey also reflects the harsh reality faced by many Malaysian children whose health is silently shaped by daily routines, social norms and limited physical activity. His story is not unique but rather a wake-up call. If childhood obesity continues to be overlooked or normalised, the long-term consequences on health, well-being and national productivity could be severe. Early intervention, family support and stronger public awareness are crucial to change the narrative – one child, one household at a time. Tomorrow: From type 2 diabetes to fatty liver and sleep apnoea, part two explores the risks of non-communicable diseases (NCDs) in children due to obesity, and highlights the importance of early treatment and public awareness. — Bernama
