Tobacco Control or Tobacco Chaos? Mexico’s Misguided Path

Lindsey Stroud

In May, Mexico marked the 21st anniversary of its membership in the World Health Organization’s Framework Convention on Tobacco Control (FCTC). Originally established as the world’s first public health treaty, the FCTC has since strayed from its core mission, increasingly advancing a misleading narrative that demonizes tobacco harm reduction (THR) products.

Despite the FCTC’s stated goals, Mexico’s smoking and tobacco use rates have not significantly declined. Worse, under the influence of billionaire philanthropist Michael R. Bloomberg, adult smokers in Mexico have been denied access to regulated alternatives such as e-cigarettes and heated tobacco products—tools that have dramatically reduced smoking rates in other countries.

Mexico signed the FCTC on August 12, 2003, ratified it on May 28, 2004, and it entered into force on February 27, 2005. The country has long had a complex relationship with the tobacco industry. Just one month after ratifying the treaty, in June 2004, several major tobacco companies pledged $400 million over 2.5 years to fund health programs determined by the Ministry of Health—with the caveat that Mexico would not raise tobacco taxes. The apparent contradiction drew intense criticism from tobacco control advocates and placed then-Health Minister Julio Frenk under scrutiny. Ironically, Frenk had been a leading contender for WHO Director-General in both 2003 and 2006, following the sudden death of Dr. Lee Jong-wook.

Before the controversial deal, Frenk had been regarded as an early proponent of the FCTC and an advocate for tobacco control in Mexico. During his tenure, the government implemented substantial tobacco tax increases, including raising the rate on unfiltered cigarettes for the first time in 20 years—from 20.9% to 110% of the retail price.

In a 2006 Wall Street Journal letter to the editor, Frenk defended his record, stating that he had consistently fought powerful interests to raise taxes, ban electronic media advertising, and increase the size of health warnings. According to Frenk, smoking among adolescents declined by 25% between 2000 and 2005.

Although Frenk was ultimately passed over for the WHO position (which went to Sweden’s Anders Nordström), he continued in academia and consulting roles. Meanwhile, Mexico doubled down on tobacco control, implementing policies such as bans on smoking in public places, advertising restrictions at points of sale, and mandatory graphic warning labels. However, the country notably resisted excessive taxation policies advocated by the WHO.

What is more troubling is Mexico’s categorical rejection of tobacco harm reduction.

In 2008, Mexico enacted a law effectively banning e-cigarette sales and marketing by prohibiting any product resembling a cigarette. In 2020, the government expanded this prohibition by banning the importation of e-cigarettes and heated tobacco products, citing youth protection and public health—despite a growing body of evidence showing that such policies often backfire.

The impact of these policies is sobering. While Frenk boasted of youth smoking declines in the early 2000s, more recent progress has stalled. According to the WHO’s Global Adult Tobacco Survey, 16.5% of Mexicans aged 15+ reported current tobacco use in 2009, compared to just 15.6% in 2023—a modest 5.5% reduction over 14 years. Current tobacco smoking declined by only 3.8% during the same period.

Rather than pivoting toward harm reduction, Mexico continued its crackdown. In 2022, then-President Andrés Manuel López Obrador issued an executive order banning the commercialization of e-cigarettes and vaping liquids. The order cited constitutional rights to health and environmental protections but relied heavily on WHO narratives that downplay or deny the reduced risk of THR products. In 2024, the Mexican Congress codified this prohibition into law.

This policy is a profound disservice to the country’s estimated 12.6 million adult smokers—a population expected to grow between 2024 and 2029.

Even worse, the ban has emboldened criminal cartels. In December 2024, The Latin Times reported that dozens of vape shops had been attacked by rival gangs. In one disturbing incident, two teenagers were paraded naked with a sign reading, “This is what happened to me for selling vapes without permission.”

Despite global misinformation, the evidence supporting THR continues to grow. The American Cancer Society acknowledges that heated tobacco products have “likely contributed to decreases in smoking in Japan.” In Hungary, increased sales of HTPs correlate with falling cigarette consumption. In the U.S., adult smoking rates among young adults have dropped to just over 5%—a level the WHO itself defines as a "smoke-free society."

Ironically, Sweden, with one of the highest rates of smokeless tobacco use (mainly snus), also boasts some of the lowest smoking and lung cancer rates in Europe.

It is long past time for Mexico to reevaluate its allegiance to the FCTC’s rigid orthodoxy. By lifting its ban on safer alternatives, Mexico could weaken illicit markets, reduce smoking rates, and support a smarter, more humane public health strategy.

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.