Hungary Should Call Out the WHO’s Harm Reduction Hypocrisy at COP11

Lindsey Stroud

More than two decades ago, on April 7, 2004, Hungary became a party to the Framework Convention on Tobacco Control (FCTC). In the 21 years since joining the world’s first global tobacco treaty, Hungary has little progress to show—yet there is cause for optimism.

In recent years, the introduction of tobacco harm reduction products, particularly heated tobacco, has led to notable declines in combustible cigarette consumption. And while Prime Minister Viktor Orbán’s office has hinted at a possible departure from the World Health Organization, it may be time for other Hungarian officials to reconsider the country’s participation in a treaty that has failed to deliver meaningful results.

When Hungary signed the FCTC in 2003, more than one-third (34 percent) of Hungarian adults smoked. By 2022, that number had only declined to 29.3 percent – a mere 13.8 percent reduction in nearly two decades. That is hardly progress.

For over 30 years, Hungary has pursued aggressive anti-smoking policies. In 1995, the country banned tobacco advertising; in 1999, health warning legislation was enacted. Subsequent years saw additional restrictions, including bans on vending machine sales, prohibitions on sales to minors, and limitations on smoking in public spaces. In 2008, tobacco promotions and sponsorships were outlawed, and by 2012, Hungary had implemented a comprehensive public smoking ban and created a network of state-run tobacco shops to control retail sales. Hungary also adopted the European Union’s Tobacco Products Directive (TPD), aligning its policies with EU mandates.

Despite this suite of interventions, smoking rates remained relatively stable—until recently.

Like many other countries, Hungary has seen substantial declines in cigarette use following the introduction of tobacco harm reduction products. A 2024 analysis using data from the Regulatory Activities Surveillance Authority found that “heated tobacco sales have skyrocketed,” while combustible cigarette sales have plummeted. In July and August 2024 alone, an estimated 300 million heated tobacco units were sold in Hungary—an astonishing 683 percent increase from January 2020, when just 38.3 million units were sold. Meanwhile, monthly cigarette sales have dropped by 7.5 million packs, translating to 150–200 million fewer cigarette packs sold in 2024.

This is real progress.

Heated tobacco is just one form of tobacco harm reduction. Despite persistent rhetoric from the World Health Organization and Bloomberg-funded public health groups, nicotine is not the primary driver of tobacco-related disease. The true harm lies in the combustion of nearly 600 ingredients in cigarettes, which produces over 7,000 chemicals – 69 of which are known carcinogens. For decades, scientists have understood that while nicotine is addictive, it is not inherently harmful. This has fueled the development of safer alternatives.

Since the invention of the modern e-cigarette in 2003, tobacco harm reduction has expanded rapidly. Today, adult smokers have access to a range of smoke-free nicotine options – including e-cigarettes, heated tobacco products (HTPs), oral nicotine pouches, and snus.

HTPs are a unique harm reduction tool due to their ability to deliver nicotine and flavor at lower temperatures without combustion. Studies comparing HTPs and traditional cigarettes show significant reductions in exposure to harmful and potentially harmful constituents (HPHCs). A 2019 review found that HTPs reduce HPHCs by at least 62 percent. A 2020 study by the American Cancer Society suggested HTPs likely contributed to declining cigarette sales in Japan. A 2022 Cochrane review found “moderate-certainty evidence” that users of HTPs are exposed to fewer toxicants than cigarette smokers. Similarly, the UK Committee on Toxicity estimated that HTP aerosols contain up to 90 percent fewer harmful compounds than cigarette smoke.

Unfortunately, public health authorities continue to dismiss the science. In 2021, the WHO released a 300+ page report – ironically titled a “global public health good” – urging policymakers to tell the public that “there is currently no evidence” HTPs reduce tobacco-related risks.

This misinformation undermines progress. The TPD’s ban on flavored HTPs will likely dampen their effectiveness in Hungary and may further boost an already-thriving illicit market. According to Major General Tamás Demeter, Vice President of Hungary’s National Tax and Revenue Authority, more than 118.5 million illicit cigarettes were seized last year – triple the amount from the previous year. Authorities also confiscated 120 tons of illegal tobacco.

Cigarette smuggling is rampant. As Demeter noted, contraband is being transported in hidden vehicle compartments, beneath cargo, and even in tins of Bulgarian goat cheese. Drones are also being used to fly packs across borders.

As a party to the FCTC, Hungary will send delegates to Geneva this November for the 11th Conference of the Parties (COP11). In 2024, Hungary was represented at COP10 in Panama by Tibor Demjén, the Ministry of Interior’s tobacco control lead, and Csaba Lőrincz, a tax expert with the National Tax and Customs Administration. At COP11, these officials must present the truth: that despite years of traditional control measures yielding minimal results, the recent embrace of less harmful alternatives is driving meaningful reductions in smoking.

Hungary’s experience could provide critical insight for countries struggling to lower smoking rates. But only if its representatives are willing to stand up and speak plainly.