Czech Republic Must Rethink WHO-Backed Tobacco Policies Amid Rising Harm Reduction Evidence

Lindsey Stroud

On June 1, the Czech Republic will mark 13 years since joining the World Health Organization’s Framework Convention on Tobacco Control (FCTC)—the world’s first global health treaty aimed at reducing tobacco-related harm. Combustible cigarettes, the primary driver of tobacco-related deaths, are responsible for over 8 million fatalities annually and cost the global economy an estimated $1.4 trillion each year.

While the FCTC’s goals are laudable, the Czech Republic has seen only modest declines in adult smoking rates since its ratification. In fact, adult smoking rates have remained relatively stagnant, even as youth smoking has significantly declined—largely coinciding with the availability of e-cigarettes, which are substantially less harmful than combustible tobacco. Unfortunately, alarmist narratives in recent years have fueled misinformation about the role of tobacco harm reduction (THR) products—nicotine-containing alternatives that provide a satisfying experience for smokers while eliminating the most dangerous aspect: combustion.

As the Czech Republic prepares to participate in the FCTC’s 11th Conference of the Parties (COP11) in Geneva later this year, delegates should take stock of the shortcomings of FCTC-aligned policies and call on the WHO to stop obstructing innovation in tobacco harm reduction. Safer alternatives are key to reducing harm for the more than one billion smokers worldwide.

The Czech Republic ratified the FCTC on June 1, 2012. In 2010, an estimated 32.3 percent of the population were current tobacco users, including those who used cigarettes, cigars, hookahs, smokeless tobacco, and newer products like heated tobacco. By 2015, the rate had only declined slightly to 31.4 percent. By 2020, the rate dropped to 30.7 percent—a mere 5 percent decrease over a decade.

In contrast, youth smoking rates have seen dramatic reductions. In 2011—just before ratification—30.6 percent of Czech youth aged 13 to 15 were current cigarette smokers, only slightly down from 31.1 percent in 2007. By 2016, after the introduction of e-cigarettes, youth smoking had plummeted to 15.2 percent, a 50.3 percent drop from 2011. Between 2016 and 2022, smoking rates declined an additional 26.3 percent, falling to 11.2 percent.

These declines correlate strongly with increased youth use of e-cigarettes: in 2022, 21.4 percent of youth reported current e-cigarette use, up from 11.2 percent in 2016.

Despite this, Czech authorities continue to follow restrictive WHO-aligned policies. In 2020, the Secretariat of the Government Council for Drug Policy Coordination released its National Strategy to Prevent and Reduce the Harm Associated with Addictive Behavior. Heavily influenced by Bloomberg-funded MPOWER policies, it emphasized measures such as advertising bans and tax increases—while virtually ignoring the potential of harm reduction. The report mentioned e-cigarettes only briefly, claiming more research was needed despite their presence on the European market since 2005.

In recent years, Czech policies have become even more restrictive. In 2017, the country began regulating e-cigarettes. In 2023, in line with EU directives, it banned flavored heated tobacco products—despite evidence from a 2025 report showing that such products were linked to a 7 percent decline in smoking. In 2024, the Ministry of Health announced plans to ban flavored e-cigarettes entirely.

Such bans are especially troubling in a country with a long history of illicit tobacco smuggling. In 2012, Czech police dismantled a smuggling ring connected to a 700-meter underground tunnel between Ukraine and Slovakia, seizing 84,000 cigarettes. In 2021, border officers broke up another large-scale criminal operation involving over 1,100 kg of illegal tobacco with an estimated street value of $6.8 million USD.

There is, however, cause for cautious optimism. Czech National Drug Coordinator Jindřich Vobořil led the national delegation to COP10 in Panama in February 2024. Although he stepped down in August 2024, he continues to play a role in shaping addiction policy.

Vobořil has been outspoken in support of THR and critical of WHO’s hardline stance. At a 2023 conference, he warned against equating safer nicotine products with cigarettes, stating: “For the last two years, [the WHO] have been pushing hard for nicotine substitutes to be regulated in the same way as cigarettes. There is something wrong with that.”

Given the failure of WHO-backed policies to significantly reduce tobacco use in the Czech Republic, delegates at COP11 must advocate for evidence-based regulation that embraces innovation. Prohibition has failed. In contrast, the introduction of novel nicotine products has led to marked declines in smoking among both youth and adults. These trends should be acknowledged, studied further, and shared globally to help other countries reduce smoking-related harms.