Lessons From Panama: Why COP10 Failed and Harm Reduction Matters

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Key Points:

• Panama’s Paradox: Host of COP10 and marking 20 years in the WHO FCTC, Panama previously banned most harm reduction products while illicit markets thrive.

• COP10 Outcomes: Delegates adopted environmental and human rights measures but delayed action on e-cigarettes, heated tobacco, and nicotine pouches until COP11.

• Ban and Reversal: Law 315 banned vaping and heated tobacco in 2022, but Panama’s Supreme Court struck it down in 2024; new regulations in 2025 now allow restricted, regulated access.

• Illicit Trade Ignored: WHO avoided confronting Panama’s massive smuggling problem – 92 percent of cigarettes sold are illicit – while illegal vaping products remain widespread.

• Hosting Controversies: The $5 million event contract bypassed public bidding; top tobacco control official faced conflict-of-interest allegations tied to Bloomberg funding.

• Bigger Lesson: Blanket bans drive products underground, cost governments revenue, and block smokers from switching to safer alternatives.

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As the host country of the 10th Conference of the Parties (COP10) to the World Health Organization’s Framework Convention on Tobacco Control (FCTC), Panama stands in a unique position this November as delegates gather in Geneva for COP11 and the nation marks 20 years as a member of the treaty this Saturday. Yet despite declines in adult tobacco use, access to tobacco harm reduction products remains restricted, and a flourishing underground market dominates the landscape. Panamanian policymakers should take a hard look at whether their own regulations are undermining progress toward one of the FCTC’s core goals: eliminating combustible tobacco use.

When Panama was announced in November 2022 as host for both COP10 and the 3rd Meeting of the Parties (MOP3) to the Protocol to Eliminate Illicit Trade in Tobacco Products, expectations were high. Originally scheduled for November 2023, the meeting was postponed to February 2024 due to nationwide environmental protests. Delegates ultimately adopted a series of measures, including a historic decision under Article 18 to integrate environmental considerations into tobacco control and a resolution linking tobacco control to human rights. The Panama Declaration reaffirmed the “fundamental and irreconcilable conflict” between the tobacco industry and public health policy, reinforcing the need for industry-free governance under Article 5.3. Stricter guidelines on cross-border advertising and media portrayals were also approved.

But some of the most critical issues – particularly the regulation of e-cigarettes, heated tobacco products, and nicotine pouches – were kicked down the road to COP11. A working group was tasked with developing guidance for future action. Discussions on Articles 9 and 10, which address product content regulation and disclosure, were also left unresolved. While delegates failed to act on tobacco harm reduction, Panama provided a living example of how bans do little to eliminate markets.

In June 2022, Law 315 banned the use, import, manufacture, and sale of e-cigarettes and heated tobacco products, regardless of nicotine content. Their use was prohibited in all public spaces, even where smoking was allowed, with narrow exceptions for imports through duty-free or special economic zones. Enforcement powers were granted to the National Customs Authority, while the Ministry of Health was tasked with oversight, public education, and sanctioning violators. Venues were required to post signage warning of the prohibition, and in 2023, Executive Decree No. 34 expanded the definitions to include all components and accessories.

In September 2023, the Panamanian Tobacco Harm Reduction Association and other advocacy groups challenged the law’s constitutionality, arguing it violated legislative procedures and citizens’ rights to health and harm reduction. In May 2024, the Supreme Court unanimously struck down Law 315 on procedural grounds. The Ministry of Health responded in January 2025 with Resolution No. 146, imposing age restrictions, advertising bans, and prohibitions on use in enclosed spaces for e-cigarettes, heated tobacco, and oral nicotine products. The resolution took effect in July 2025, marking a shift from outright prohibition toward regulated access.

Yet COP10’s legacy in Panama has been clouded by controversy. The $5 million taxpayer-funded contract to host the event at the Panama Convention Center was awarded without a public bidding process, raising concerns over violations of Penal Code Article 338 and UN anti-corruption standards. Further scrutiny fell on Reina Roa, coordinator of the National Tobacco Control Commission, who faced accusations of administrative irregularities and conflicts of interest, including receiving Bloomberg Philanthropies funding through the Panamanian Coalition Against Tobacco Use while serving as an advisor to the Ministry of Health.

The deeper failure, however, lies in the absence of better tobacco control outcomes. COP10 was more about optics than protecting lives, serving largely as a platform for advancing prohibitionist policies championed by Bloomberg-funded organizations. Even more troubling was the WHO’s disregard for the scale of Panama’s illicit tobacco trade – despite convening a conference in a country where an estimated 92 percent of cigarettes are smuggled and where illegal vaping products remain widely available.

With COP11 now less than 100 days away, delegates and policymakers must recognize the damage caused by overregulation and blanket bans. Driving products out of sight or into underground markets does nothing to curb demand; it only fuels illicit trade, deprives governments of tax revenue, and obstructs the transition away from combustible tobacco. If Panama’s experience as COP10 host proves anything, it’s that prohibition is no substitute for effective, evidence-based harm reduction.

Nothing in this analysis is intended to influence the passage of legislation, and it does not necessarily represent the views of Tobacco Harm Reduction 101.