GFN25: The Right to Breathe Another Story
Three days in Warsaw during GFN25, where the science of nicotine dismantled its straw men — and disinformation was called by its name
There are conferences, but there are also gatherings that resemble true assemblies of castaways: survivors of the high tide of misinformation and the murky currents of official discourse that anchor their existence in forgotten evidence, in data buried beneath ideology, in voices that institutionalism insists on silencing. Many return to Warsaw, year after year, not to be persuaded, but to preserve their integrity in a world bent on fragmenting them.
This is the case with the Global Forum on Nicotine — or simply GFN — an annual conference that, since 2014, has established itself as the epicenter of an underground battle between science, politics, and public perception. It is a symbolic terrain where the very sense of the word “truth” is reclaimed amid a narrative din that turns error into caution and censorship into prudence.
In 2025, the event marked its 12th edition under the banner "Challenging Perceptions: Effective Communication for Tobacco Harm Reduction." More than merely a title, the phrase rang out like a password—a summons to rational uprising on terrain where language is weaponized and every word digs trenches.
In Warsaw, across three intense days in June, it was not merely a political-scientific forum but a collective effort to name what remains concealed. Between coffee breaks and political confrontations, one unsettling question emerged: What happens when truth is outlawed by decree?
Those Who Return to the Place Where They Were First Heard
The Warsaw President Hotel (formerly the Marriott), a cosmopolitan structure without a hint of ostentation, welcomes the event year after year. Yet behind its neutral carpets and air-conditioned corridors, what unfolds there is far from indifferent. There is an unrelenting human pulse, and this pressing need for connection infiltrates every coffee break, every elevator line, every badge swap.
At GFN, communicating isn’t just about conveying information—it’s about contesting meanings. On this dogma-laced terrain, strewn with half-truths and agendas disguised as public health, challenging perceptions demands more than data: it requires courage. Courage to give voice to silences, to narrate the invisible, and to assert the right to nuance in an age of extreme polarization.
There, amid auditoriums and corridors, one almost senses a devotion to an idea that is both simple and revolutionary: harm reduction has proven its efficacy, and it must be communicated with unflinching honesty.
It isn’t a matter of faith but a discovery underpinned by decades of empirical evidence, accumulated experience, and lives transformed. The numbers speak for themselves: higher cessation rates, steady declines in smoking-related disease indicators, and concrete success stories in countries like Sweden.
But what truly moves us—more than any graph—are the faces that give life to the statistics: the stories of those who quit smoking thanks to access to lower-risk products; of those whose health ceased to be a foregone ruin and became a chance to endure.
This platform is hosted by Global Forum on Nicotine Ltd, an organization that fuels international public-health debate through a radically inclusive lens. Its mission transcends the purely scientific: it is also political and ethical. It brings together a chorus of diverse voices — experts, consumers, legislators, activists, and journalists — to challenge the rigid doctrine that absolute abstinence is the only acceptable response to smoking. GFN asserts the opposite: reducing risk, even without total elimination, is a public-health priority — and a fundamental human right.
There, perfection isn’t celebrated—it’s progress. Perhaps that’s why, year after year, the forum transforms into a space where hope transcends mere words and becomes shared practice—and where knowledge finds its most authentic political expression.
The Hotel Where Smoke Doesn’t Enter — but Stories Overflow
One of the conference’s most provocative panels aimed to revisit the 20-year history of the Framework Convention on Tobacco Control (FCTC) — the global treaty spearheaded by the World Health Organization and often lauded as a historic milestone in the fight against smoking. What might have been a purely technical session—dressed in diplomatic jargon and formal statistics—swiftly took on a tone of denunciation and ethical urgency.
The session was opened by Jeannie Cameron, one of the most influential voices in the debate over tobacco policy, trade, and regulation. Known for her critical scrutiny of the FCTC’s performance, Cameron did not hold back in her address, unveiling contradictions and challenges that have long been silenced.
With almost surgical detachment, Cameron stripped away the uncritical enthusiasm that still surrounds the treaty, arguing that, despite the political and legal advances propelled by the FCTC, its core mission—actually reducing smoking rates and deaths linked to combustible products—remains unfulfilled.
According to the speaker, this failure stems from the systematic refusal to fully and coherently embrace harm-reduction strategies—explicitly provided for in the Convention’s own text, yet sidelined by numerous governments and the treaty’s governing body. She labeled the WHO’s stance as “vehemently anti-harm reduction” and denounced the FCTC’s “overly clinical” approach, which in practice translates into a binary, dehumanizing policy: “quit or die”—with no room for more pragmatic, accessible, and compassionate solutions.
Her words hovered in the air like both accusation and lament. Instead of embracing the complexity of human behavior or acknowledging the promising role of emerging technologies, the treaty sought refuge in the comfort of orthodoxy: either you quit cigarettes entirely, or you remain condemned. Within such a narrow framework, products like snus, vaporizers, and nicotine pouches—demonstrably less harmful than traditional cigarettes—have been systematically ignored or swept out of the discussion. Not for want of evidence, but for an excess of moralism.
And the result, as Cameron and other panelists argued, is tragic: millions of lives that could have been saved have been left adrift by a treaty that persists in refusing to recognize harm reduction as a legitimate public-health strategy. Though the FCTC erected a robust diplomatic and legal architecture, it faltered precisely where it could not— in the concrete saving of human lives.
Alongside Cameron, Clive Bates, an astute public-policy analyst and veteran champion of evidence-based regulation, delivered his critique with the precision of someone who masters the nuances of institutional power. Blunt and incisive, he quipped: “If you have a fundamental principle, and a case like snus contradicts it, then the principle must change. It’s like general relativity—if an observation contradicts it, it’s over.”
The FCTC was born as a plan of cooperation—a bridge built between nations in the name of health. But in many contexts, it has become its opposite: a wall. A wall raised against science, against consumers, against innovation. And this is not merely a metaphor, but a diagnosis: a structural symptom of the contradictions that permeate the architecture of global public health.
What should have been a pact of protection and mutual learning has, all too often and with alarming frequency, become a mechanism of epistemic exclusion: walls erected against science by refusing to revisit assumptions in light of new evidence; walls against consumers by denying agency to those who grapple daily with real choices between risk and reduction; walls against innovation by meeting departures from orthodoxy not with curiosity, but with suspicion—or silence.
With incisive clarity, Bates and Cameron’s critique laid bare a moral fracture in the tobacco debate: the orthodoxy of absolute abstinence stands as an unassailable doctrine, despite its toll being counted in lives lost.
From this vantage, the FCTC’s failure transcends mere technical hurdles and reveals itself as an ideological clash. It is a global architecture that, in the name of regulatory purity, has rejected the saving imperfection of harm reduction. Its institutional edifice retains an elegance buffed by the varnish of diplomatic consensus, yet remains blind to the fissures widening at its foundations: the systematic exclusion of consumers; the refusal to embrace technological innovation; and the deliberate suppression of evidence that escapes the abstinence dogma.
This critique is no mere rhetorical exercise but is grounded in concrete data and in cases that demand attention. Swedish snus—a non-combustible oral tobacco product consumed for decades across Scandinavia—illustrates this reality. Thanks to its widespread adoption, Sweden now has one of the lowest lung-cancer incidence rates in Europe. And this is not a simple correlation, but causation, supported by decades of rigorous epidemiological research.
Yet snus remains restricted throughout much of the European Union. Why? Experts at GFN insist the reasons are political, not sanitary. The problem doesn’t lie with the product itself, but with its incompatibility with an institutional narrative that draws an inflexible and moralistic boundary between vice and virtue.
Instead of opening pathways to viable solutions, the treaty has reinforced the walls of stagnation. Under the banner of a “purified” public health, the FCTC has chosen to turn a blind eye to life’s inherent ambiguity—and it is this disdain for the ambivalent that exposes its greatest vulnerability.
For low- and middle-income countries, this refusal to entertain less harmful alternatives takes on even more dramatic proportions: it amounts to denying options that could save millions of lives. Tikki Pangestu, a renowned global health specialist and former Director of Research and Policy Cooperation at the WHO, highlighted one of the most severe, and paradoxically silenced, consequences of this institutional stance:
“WHO holds a very strong position against harm reduction — and this has a disproportionate impact on low-and middle-income countries.”
This indictment lays bare one of the most asymmetric harms imposed by the WHO. Pangestu underscored that, in settings with fragile health systems and high smoking prevalence, the refusal to adopt harm-reduction strategies amounts to a structural health injustice, perpetuating inequalities in access to safer alternatives.
Speaking with the authority of someone who moves behind the scenes of global health diplomacy, Tikki Pangestu did more than offer an observation—he sketched out a diagnosis. In countries with a fragile capacity to generate and interpret scientific evidence, which is often subordinated, WHO guidelines function as silent directives, not through overt coercion, but via a political-economic dependency that takes root like invisible tendrils.
“Policymakers in these countries often rely on studies from the U.S. or Japan — but what they really need is local data, and that’s precisely what is most lacking in many of these settings,” he explained.
This vacuum, compounded by diffuse bureaucratic inertia, means that if the WHO declares vaping to be as harmful as smoking, governments swallow that stance without question. What should serve merely as guidance becomes an imposition, not through direct coercion, but through the simple absence of alternatives.
This asymmetry—so often hidden beneath the veneer of technical discourse—amounts to a true form of sanitary colonialism: a mechanism by which the normative expertise of central countries dictates, without mediation or dialogue, the policies imposed on peripheral contexts.
Pangestu went even further in his critique, asserting that this dogmatic stance not only persists but continuously gains strength:
“The WHO reinforced this position even further during COP10, and shows no signs of changing it for COP11. As long as this stance remains, many countries will remain passive, simply repeating: We follow WHO.”
This passive acquiescence lays bare a cruel paradox: precisely in the regions where tobacco kills the most, the most effective tools to fight it remain out of reach, not for lack of evidence, but for lack of autonomy. And, as Pangestu concluded, with a lucidity tinged by resignation, reversing this tide will not be a technical decision, but a political act:
“The only way to change this is for a Minister of Health to pick up the phone, call the WHO Director-General, and say: ‘We want this issue on the agenda.’”
In Pangestu’s words, the line between scientific inertia and moral omission has grown blurred because sometimes having the evidence isn’t enough; you need the courage to hear it.
In contexts where dependence on international guidelines outweighs the strength of local research, the WHO’s normative influence operates as a silent command. Policies are replicated mechanically or imposed like ghostly shadows, sacrificing scientific autonomy in the name of a one-size-fits-all model that ignores each region’s cultural and health realities.
It isn’t science that’s being exported. It’s doctrine. A sanitary universalism that confuses consistency with truth and standardization with justice. The result is a one-size-fits-all public health model—blind to cultural, social, and economic nuances; deaf to the pragmatic solutions that could, in effect, save lives.
What emerged from that panel was not merely a critique of an international treaty’s failures, but a call for re-humanization —an appeal for public health to rediscover its ethical vocation: listening, adapting, and caring. And, above all, to abandon the illusion of a single solution to smoking, for, as the panelists reminded us, life does not fit into binaries.
When Science Must Wear Armor
One of the most intense—and at once most unsettling and illuminating—moments came during the Michael Russell Oration, delivered by Arielle Selya, a scientist who does more than research: she resists. Her journey defies the official script. She once harbored the same alarmist fears about electronic cigarettes until the very data she was collecting revealed a different story—one far more complex and far less convenient.
And she paid a price for listening to it.
Selya stated that today, science is actively discouraged from telling the truth. When findings contradict the dominant narrative, the customary response is not rigorous scrutiny but silence. She recounted having a funding proposal rejected when she neutrally and impartially suggested studying the effects of e-cigarette use among young people. The reason for the rejection? The assertion that “it would not be advisable to encourage e-cigarette use among adolescents, even though they are safer than traditional cigarettes.”
Uttered with near-clinical composure, her words struck the audience as both indictment and testimony from someone who has already endured the academic isolation reserved for those who refuse to bow. What Selya exposed was not merely an imbalance in scientific output, but an ethical erosion at the very heart of the knowledge ecosystem.
With unsettling clarity, she revealed how ideological preferences and political pressures taint research funding systems. Studies that emphasize risks—even when methodologically weak—garnish funding and applause; meanwhile, investigations highlighting the comparative benefits of reduced-risk products face suspicion, budget cuts, and, all too often, ostracism.
Science, in many cases, has become complicit in institutional fear, not through active falsehoods, but through the silence and omission where there ought to be courage.
In the corridors—where badges had yet to erase our given names—the conversations took on a more intimate, and thus more brutal, tone. Between sessions, an unsettling whisper began to circulate, one that would hover over the days to come: “We’re scientists trying to save lives — and they treat us like criminals.”
That remark came from a researcher who studies data on e-cigarette effectiveness in rural communities—and who has already received threats from the Ministry of Health itself. His “offense”? Publishing findings that demonstrate harm reduction works—even where the State insists it shouldn’t.
That tension between the science determined to save lives and the powers that silence it has become, perhaps, the forum’s unspoken fulcrum. For in a world where facts are sifted through the sieve of ideology, truth demands armor—and those who defend it, a courage almost anachronistic.
As in every good and faithful narrative, we find unlikely heroes: scientists who resist co-optation; activists who grasp the weight of each statistic embodied in living flesh. But there are also martyrs: researchers silenced, studies buried, voices extinguished before they could become too inconvenient.
Perhaps nothing captures the atmosphere of GFN25 better than Arielle Selya’s closing words.
She closes her address with a rare and potent gesture: creating space to listen to others, even those who dissent. By affirming her faith in adversarial collaboration, she does more than endorse dialogue with opposing viewpoints—she elevates it to a scientific method in its own right. To design a study alongside someone who thinks differently, agreeing in advance on which criteria each party will deem robust evidence, is to restore to science what so often slips away: a commitment to truth, not to the confirmation of preexisting beliefs.
But Arielle doesn’t stay confined to the epistemic realm. She moves into concrete terrain to remind us that, ultimately, science has a profound impact on real lives. It is here that her most humane critique takes shape: while other fields have long recognized that no research is legitimate without the active participation of those affected, tobacco research still silences the very people it concerns. In that void echoes the old slogan—“Nothing about us without us”—an ethical rallying cry she reclaims with unwavering resolve and the hope that this overdue change will finally come to pass.
In an almost intimate moment with the audience, Arielle invites listeners to share their stories. For, as she reminds us, facts—essential though they are—do not always suffice. It is often emotion that breaks down barriers and makes space for change. At this juncture, her words take on the weight of a legacy: for those who practice science, the responsibility to pursue it with excellence; for those who receive it, the duty to champion it with integrity.
At last, she invokes Schopenhauer’s philosophy. Schopenhauer. Truth, the Polish thinker teaches, unfolds in three stages: ridicule, hostility, and, at last, acceptance. In this, Arielle leaves us with an almost historic sense—perhaps we now stand on the threshold of that final phase, when what was once met with vehement resistance begins, slowly, to become self-evident.
In that room, where silence bore the weight of applause, her words were not merely heard—they were felt. Like a summons. Or a warning.
At GFN25, this underground narrative pulsed through the corridors and coffee breaks like a discreet hemorrhage. What was at stake was not merely the reputation of a public-health policy—slow, yet inexorable—but the integrity of science as a civilizational engine.
And at the heart of it all, a question both simple and brutal: Who is willing to pay the price for speaking the obvious, when the obvious has become dangerous?
Against Fear, a Book
On the forum’s opening night, Dr. Mark Tyndall took the stage with quiet restraint. The next day, he would launch his new book, Vaping Behind the Smoke and Fears, in conversation with Harry Shapiro. Yet even in that first moment, there was something liturgical about his entrance—a gesture that transcended the conference and felt like a rite: understated, yet intensely symbolic.
His address formed a powerful ethical tapestry, intertwining his path as a physician and harm-reduction advocate with an unflinching critique of how public health—especially tobacco control—has failed to adopt approaches rooted in compassion, evidence, and pragmatism.
Infectious-disease specialist and field researcher, a seminal figure in harm reduction, Tyndall moves effortlessly between academic corridors and the alleyways of human experience. Perhaps that’s why his book reads less like a thesis and more like a trench memoir. In it, he recounts his own transformation—from public-health physician to reluctant activist: in today’s climate, suggesting that nicotine devices might serve as allies in the fight against tobacco draws an invisible line between the “respectable” and the “heretics.”
Based on clinical experiences presented as concise real-life vignettes, Tyndall distills and systematizes lessons from a career devoted to listening and caring. He shows that, over the decades, harm-reduction strategies—condoms, clean syringes, supervised consumption sites, controlled opioid distribution, and, more recently, lower-risk nicotine products—have proven effective, straightforward, grounded in robust evidence, cost-effective, scalable, and, above all, embraced by those who need them most.
Still, the Canadian physician highlights a stark contradiction: these interventions remain controversial not because they fail to achieve their goals, but because they challenge punitive ideologies, entrenched stigmas, and institutional apathy. In his view, there is a persistent reluctance to acknowledge that risk behaviors are part of the human condition—and that medicine’s ethical mandate is not to punish choices, but to protect lives.
For Tyndall, the moralism underpinning much primary-prevention policy fails to accommodate the complexity of substance use and the unique journeys that drive it. He decries the structural stigmatization of drug and nicotine users—and points out that, if those users were all white and wealthy in the Global North, social responses would be radically different.
Without hesitation, he also calls out the colonial bias of influential billionaires like Michael Bloomberg, whose political interventions export prohibitions to the Global South—measures that would never be tolerated in the United States or Europe.
Furthermore, he admonishes the entrenched institutional inertia—both of the health system, which benefits from the perpetuation of chronic, tobacco-related diseases, and of tobacco-control bodies, shackled to an abstinence-only paradigm that proves either incapable or simply unwilling to question its certainties. Even the tobacco industry, he argues, seems more intent on regulating the pace of transition than on spearheading a genuine transformation.
Finally, he highlights the legal paradox that, in countries like Canada, even the act of informing is criminalized: simply stating that vaping is less harmful than smoking becomes, in itself, an offense.
In light of this scenario, Tyndall outlines three urgent courses of action:
Community activism, driven by users and those directly affected;
Targeted political advocacy, grounded in scientific evidence and bolstered by respected voices;
Strategic use of the judiciary to secure the right of access to safer products.
He closed his lecture with a daring analogy to the HIV epidemic: just as delays in rolling out antiretrovirals cost millions of lives in Africa, today’s resistance to expanding access to cigarette alternatives perpetuates the same lethal neglect. To Tyndall, it is no mere metaphor: denying people lower-risk nicotine products is, in effect, sentencing them to avoidable deaths.
But his address didn’t end in the auditorium. The next day, during the launch interview with Shapiro, the other side of his journey was laid bare: the personal cost of stating the obvious.
He recounted how, by championing harm reduction, he became persona non grata in numerous professional circles. He recalled being boycotted by Vancouver public health authorities at the inaugural vaping event in 2018 and being uninvited from a public debate with Stanton Glantz when the organizing committee labeled his presence “a mistake.”
He also spoke of colleagues’ lack of understanding, the media’s distortion of his statements, the erasure of nuance, and the moral panic that permeates institutional discourse. In Tyndall’s view, the greatest danger does not lie in misinformation, but in the lucrative mining of fear. The true beneficiaries, he implied, are not the manufacturers of nicotine products, but those who turn panic into public-health doctrine.
In a few words—laden with restrained frustration and a long memory—Tyndall laid bare the core of the problem: the industry of fear has become more profitable and more socially acceptable than the very tobacco industry it claims to fight.
In the end, there was no dramatic clash, nor a rhetorical question to split the night in two. Yet as he recounted his years of public advocacy—the friction with colleagues, the silence of institutions, the shrinking of spaces that once welcomed him—it was impossible not to hear the unspoken question hovering in the room: what was the personal cost of carrying on?
Tyndall never spelled it out in words. Yet in the tone of his voice and the deliberate rhythm of his sentences, the answer was unmistakable. The cost was real—measured in lost invitations, professional estrangements, and the subtle erasures that accompany dissent. Still, there was something that transcended the price paid: a conviction that outlasts loss, and the peace of knowing that lives were changed—that people quit smoking not because of the system, but because someone refused to follow it.
This tension between exclusion and purpose distilled one of GFN25’s deepest emotional truths: in today’s global-health landscape, speaking the truth about nicotine is not merely controversial—it’s costly. And yet, for those who persevere, it remains an ethical act.
That night, more than a stance was launched. And the next day, more than a book. What emerged was a model: the refusal to trade prestige for omission—a powerful reminder of what truly matters, and that some silences don’t protect—they kill.
At the End of the First Day, the Word
When the Warsaw sun dissolves against the glass facades of the convention center, GFN25 doesn’t close with applause but with a kind of fatigue that isn’t physical—it comes from facing the naked truth. The truth that communicating science in times of moral hysteria is like walking on shards of glass; that challenging entrenched narratives can cost reputations, funding, and invitations—and yet, silence costs even more.
This year’s theme, “Challenging Perceptions: Effective Communication for Tobacco Harm Reduction,” proved to be less slogan and more diagnosis. What unfolded was not a parade of certainties but a collective effort to reclaim the word as a bridge, not as a trench. To speak of flavors, of snus, of human rights, and of safer alternatives to smoking is not—as some still insinuate—surrendering to the industry. It is refusing to surrender to indifference.
In the auditoriums, in the corridors, in the makeshift cafés where accents blended, there was a palpable sense of community—a community keenly aware of what’s at stake: not merely statistics, but the chance for a public policy that listens to the living before counting the dead.
For all good science is, at its core, an act of language, and every act of language, when wielded with honesty, has the power to save.
And so the first day ended: with more questions than answers, but with more courage than silence.
When Speaking the Truth Becomes a Crime
Some sessions at GFN25 were laden with ethical tension and emotional candor. In several of them, the aim was to discuss the role of leadership, communication, and authority in transforming public policy. But what emerged—amid personal testimonies, institutional diagnoses, and courageous exposés—was something deeper: the human—and at times legal—cost of leading with courage in a field where speaking the truth has, paradoxically, become a risk to manage.
Canadian activist Maria Papaioannoy-Duic delivered testimony that left the room frozen. In Canada, vape-shop owners can be sued—even jailed—for telling customers that e-cigarettes are significantly less harmful than traditional cigarettes. This isn’t opinion but an estimate grounded in official Public Health England assessments—yet merely repeating the fact on Canadian soil can amount to a crime. “It’s easier to buy a pack of cigarettes in Canada than a product specifically designed and approved to help you quit smoking.”
Maria can legally sell cigarettes plastered with images of necrotic lungs on the packaging—which perhaps only desensitizes consumers—yet she cannot utter a single word about the potential benefits of vaping. This, she argues, is not a public health policy. It is censorship. And it is not the product of ignorance, but of deliberate institutional decree.
Greek cardiologist Konstantinos Farsalinos, one of the most influential voices in nicotine research, spoke with his trademark candor. To him, the cost of official misinformation is not abstract: it’s measured in lives lost. And when scientists—despite knowing the data—choose silence, they cross an ethical line: the one between prudence and complicity. “Delaying access to safer products in the name of endless studies costs lives — this is not a metaphor. It’s an accusation.”
Irish general practitioner Garrett McGovern, who has spent decades working in vulnerable communities, expanded the scope of the discussion. He recounted the case of a patient with severe COPD, who had part of her lung removed, yet still smoked thirty to forty cigarettes a day. When he asked her pulmonologist about e-cigarettes, he was told, “They’re just as bad as smoking.”
McGovern didn’t hesitate: “It’s almost impossible to pierce the medical mainstream with evidence. Popcorn lung, youth epidemic, developing brain… It’s the same myths, recycled without scrutiny.” He went further, calling misinformation a genuine institutionalized epidemic: doctors repeat dogmas out of ignorance or inertia, and the ones who suffer most are the patients, especially the most vulnerable.
Portuguese harm-reduction veteran Adriana Curado was emphatic: tobacco remains “normalized” among marginalized groups—and thus invisible. In services for opioid, alcohol, or crack users, smoking is treated almost as a concession, tolerated, but never confronted. That omission, she warned, comes at a high cost. “If harm reduction is a movement that fights prohibition, then we cannot accept prohibitionism when it comes to nicotine. Regulation is urgent — to protect, not to punish.”
According to Curado, the absence of safe, accessible products—especially for the most vulnerable—is the most significant barrier to cultural change. Without free access, public infrastructure, or political will, the discourse on harm reduction collapses into empty rhetoric.
Jessica Harding, an experienced and brilliant advocate, pinpointed the root of the problem: the debate’s toxicity. In an environment where aligning oneself with harm reduction can jeopardize reputations, evidence is sacrificed—becoming the victim—and silence is chosen as a strategy of self-preservation.
Sharifa Ezat Wan Puteh, from Malaysia, described the climate of fear that grips her medical colleagues. Speaking of vaping as a cessation strategy can invite retaliation.“The repression is so intense,” she said, “that many of us operate underground — even within universities.”
As for Carolyn Beaumont, from Australia, she shared a rare exception: psychiatrists have been referring patients to her clinic in recognition of vaping’s role as a therapeutic tool, even without knowing precisely what to prescribe. A gesture of clinical humility that, for her, paves the way for a new kind of dialogue: between medicine and the reality of patients.
Rowan Pike, also from Australia, reminded us that even public‐safety forces are swept up in prohibitionist policies they don’t endorse. “We’ve set them up to fail,” said one officer, referring to the burden of enforcing incoherent regulations.
Michael Stoney, director of Scotland’s largest prison, recounted a paradigmatic case from the Scottish penal system. In 2019, when tobacco was banned in the prison wings, the state braced for riots. The solution—offering free vapes alongside nicotine-replacement therapies—proved surprisingly effective. The result? A 90 percent reduction in indoor air pollution, a drop in respiratory medication prescriptions, and not a single serious incident.
There was no chaos — there was care.
“The legitimacy of decisions, inside a prison, is not theoretical,” Stoney said.
“If they’re not perceived as legitimate, the consequences come — and they come fast.”
Tony Duffin, a veteran of drug-policy reform, distilled what was perhaps the panel’s most precise point of consensus: it isn’t about speaking for affected communities, but about talking with them. Co-production is more than a methodology—it’s a restoration of dignity.
Among the most forceful proposals discussed were forming commissions of former public-sector leaders, capable of genuine peer-to-peer dialogue; engaging religious authorities, especially during periods like Ramadan; and deliberately including users and consumers as permanent members of decision-making bodies, not as exceptions but as the norm. Because today, what’s truly on trial isn’t the products themselves, but the right to speak the obvious without fear of punishment.
Real Lives, Invisible Stories
The science of harm reduction is solid, and what’s lacking isn’t evidence but institutional courage to recognize who and what have been left out of the picture.
On the panel “Who Else Should Be in the Room?”, moderated by Martin Cawley, a disquieting question surfaced: why are those most affected by risk still excluded from decisions about how to reduce it? “We have clinicians, researchers, scientists—so who’s missing?”
What followed were not tales of victimhood but fragments of resistance in a system designed to protect the orthodoxy of a few rather than the health of many.
Yet the absence that hurt most was that of the most basic principle of democratic public health: nothing about us without us. The exclusion of users—their bodies, their voices, their choices—was revealed not as an accident but as a symptom of a collapsing paradigm that normalizes the invisibility of those we most need to hear.
Amid this bitter realization, a comforting anchor resonated in the words of Mark Tyndall, spoken at another moment in the forum: “We are on the right side of history.”
These products—if they reach the hands of those who need them most—can save millions of lives. The question is no longer whether they work; the question is who gets to decide who deserves access to them.
What ran through these sessions was not merely a defense of harm reduction but proof that, in certain contexts, defending science has become an act of dissent. To lead here is not to echo consensus but to resist the seductive trap of institutional silence, which promises professional safety at the cost of truth. It is to recognize that, in public health, having a voice is itself a political act—and as long as the most vulnerable are treated as faceless statistics, any policy will remain tainted by omission.
Science (as journalism) may naively aspire to neutrality. Its application—or its denial—never will. Because denying a solution isn’t hesitation; it’s a choice. And every choice has its victims.
When Truth Demands Translation: The Battle for Words
On the second day of GFN, the rooms were even more crowded. It wasn’t just the density of topics that had increased, but the moral gravity of what was at stake.
If the first day was devoted to unmasking institutional omission—the silences, the shelved data, the doors slammed on innovation—the second plunged into the active perversity of disinformation: the kind that not only denies truth but distorts it, ridicules it, criminalizes it. Lies capable of infiltrating headlines, donning the guise of public policy, and embedding themselves even in the guidelines that educate doctors and journalists, silencing futures.
This was no longer a matter of isolated mistakes, but of a political intent that had been transformed into public panic. The official narrative, bolstered by an alleged scientific consensus, felt increasingly like a shadow play: the terms remained familiar, but their meanings were drained—or inverted. To speak of harm reduction in such a context was also to debate who has the right to tell the story—and, more so, who is systematically left out.
The tension reached a critical pitch, particularly around the media’s role in reshaping risk perception, amplifying fear even as it smothers nuance.
As journalist and author Jacob Grier observed when reflecting on U.S. coverage of the EVALI outbreak: “Millions of deaths from cigarettes don’t make headlines. But a few dozen cases linked to adulterated [THC] vapes generate months of sensationalist coverage.”
It is within this asymmetry of attention that our collective imagination is forged—a world where the real danger is no longer the cigarette that kills, but the lower-risk product that might replace it. At the heart of this distortion lies a problem that is not merely semantic. It is political. It is economic. It is morally lethal.
This realization—uttered with quiet skepticism, almost resignation—distilled the very core of GFN25’s challenge: the battle for public health’s future is waged not only in laboratories or technical committees but, above all, in the terrain of language. What’s at stake isn’t just what we know, but who has the right to speak, to be heard, and to remain a legitimate source of truth. In this arena, data can be ignored—but narratives endure: facts may have a short lifespan, but stories shape decades. And that is why harm reduction faces not only scientific resistance but a political-economic narrative regime designed to silence dissent.
The Power of the Headline and the Silence of Nuance
Journalist Jacob Grier — known for his critical stance on tobacco-control policies—took the stage with the composure of someone watching a fire from afar, yet still feeling its heat and tracing the smoke back to its source. In his talk, titled "Tobacco Harm Reduction and the Media: Evidence, Narrative, and Consequences", he performed a surgical dissection of the dissonance between what is known and what is reported; between the science that documents and the media that dramatizes.
With concrete examples, Grier dismantled the media spectacle: in cities like Portland, where flavored cigarettes are banned, strawberry-flavored alcoholic beverages or child-candy-branded cannabis products remain on sale.
"Banning menthol vapes while glitter vodka remains widely available has nothing to do with public health — it's regulatory hypocrisy," he declared, drawing a mix of nervous laughter and uneasy nods from the audience.
His most incisive point came when he addressed the erosion of nicotine’s cultural legitimacy: every new restriction—even those lacking a solid basis—normalizes the next, and what begins as an exception soon hardens into dogma. Each alarmist headline paves the way for yet another prohibition. In the process, we lose not only scientific debate but also the right of adults to choose.
Grier was unequivocal: “Informed adults should have the right to decide what they put into their own bodies. And access to the safest form of a substance cannot be denied while the deadliest remains available on every street corner.” His argument was not a superficial libertarian plea but a vision of freedom grounded in political maturity, evidence-informed autonomy, and a refusal to treat citizens as perpetual minors.
Next, veteran journalist and esteemed writer Harry Shapiro — one of the most respected voices in drug policy and health-communication circles—responded not with alarmism, but with clarity honed over four decades of mediating between science, media, and society. Rather than demonize journalists, he invited them into what he called a “demilitarized zone”—a space where nuance can still survive in a media culture hungry for extremes.
Shapiro noted that, concerning tobacco harm reduction, the weight of evidence tilts heavily in one direction. Yet media narratives often spotlight extreme cases—like the thirteen-year-old who takes up vaping and can’t stop—while ignoring broader realities. He acknowledged the challenge of addressing these stories without seeming indifferent or conceding the wrong point. His remedy: shift the focus to adult smokers, especially marginalized groups whose suffering is ongoing and well-documented.
He reminded the audience that 80 percent of the global burden of tobacco-caused death and disease falls on the world’s poorest regions, and that the most vulnerable populations—people with mental-health disorders, drug dependence, Indigenous communities, and LGBTQIA+ individuals—need more options, more access, more listening, more tools to stay alive.
The universal right to health, he emphasized—enshrined in the WHO Charter of 1948, “applies to everyone, whether or not you approve of their lifestyle.”
Finally, Shapiro underscored that harm reduction should not be viewed as an adversary to traditional tobacco-control strategies, but as a complementary approach—one that already boasts sufficient medical evidence to be responsibly recommended by health professionals.
In an era when misinformation proliferates, his message to communicators was subtle yet urgent: change the narrative, broaden the frame, and tell the real stories before someone else distorts them.
Australia and the Inverted Map of Public Health
If Jacob Grier exposed the media's capture of the narrative, Fiona Patten took the debate one step further, showing how that very narrative has shaped public–health policies that are not only ineffective but downright cruel. Renowned for her parliamentary work and her activism in favor of pragmatic drug and sexual health reforms, Patten took the stage without preamble:
"Australia, once a global leader in harm reduction, has become the village idiot of the world."
This was no mere acidic metaphor; it was a tragic diagnosis.
While Australia proudly proclaims its “world-leading tobacco-control program” on the international stage, the numbers tell a far less heroic story: for every legal e-cigarette sold in pharmacies, an estimated 1,700 devices are bought on the black market. This fuels an unregulated economy, free of quality control, taxation, or safety standards—a gift to organized crime, stamped with the official seal of public health.
Even more urgent, Patten warned, is the climate of intimidation and narrative control that surrounds this issue. She described a scenario in which health journalists hesitate to challenge the official line, fearing not only government retaliation but also that of influential bodies like the Cancer Council. Researchers, she alerted, see their funding threatened. Consumers are systematically excluded from legislative debates, their autonomy crushed under the weight of growing bureaucratic authority.
Patten sketched a portrait of a “virtual prohibition” disguised as public health policy—a system so self-contradictory that even law-enforcement officers admit it no longer works. She pointed out regulatory absurdities: while strawberry vodka and child-branded cannabis remain on sale, flavored nicotine pouches are banned.
In Australia, she noted, even the few nicotine products still legally available in pharmacies will be criminalized as of July 1, deepening a market distortion that already fuels a $13 million-a-day illicit industry—complete with territory wars, arson, and even murder. An innocent woman was killed by mistake in one of these conflicts. “No one seems willing to make the connection between that tragedy and the legislation that helped cause it.”
For Patten, this isn’t just regulatory failure—it’s a case study in how prohibitionist laws generate the very harms they claim to combat.
Underlying her critique was a deeper concern: the erasure of adult agency. In debates over flavor bans or nicotine alternatives, she observed, almost nobody stands up to defend the right of informed adults to choose what they consume. Instead, restrictions pile up, one after another, each making the next easier to justify—a ratchet effect that reduces people first to patients, then to problems.
Beneath it all, she warned, lies a technocratic paternalism—the assumption that experts, not citizens, should decide which pleasures are permissible. That, she argued, is actual authoritarian deviation: not in the state’s coercive power, but in the silencing of dissent.
As she spoke, delegates from other countries, like Asa Saligupta of Thailand, nodded in recognition. The repercussions of this crackdown are not confined to Australia; the silence that shrouds them, however, is carefully cultivated as part of a deliberate strategy of global omission.
Flavor as Bridge: Taste, Science, and Choice
By this point on the second day, it had become clear that the heart of harm reduction is not merely scientific; it is experiential. Few topics capture this tension more powerfully than the debate over flavors, in a world where official discourse still romanticizes nicotine solely as medication, speaking of the sensory dimension of quitting smoking borders on heresy. However, at GFN25, these heresies are not only welcomed but also embraced.
In the panel dedicated to flavors, moderated by Ian Fearon — a health policy consultant with nearly two decades of experience — the proposal was both bold and straightforward: to remove flavors from the moral caricature and restore their real function — that of a bridge: a bridge between a habit that kills and an alternative that might save.
Toxicologist Autumn Bernal presented data that dismantled the alarmist narrative:
More than 99% of e-cigarette aerosol mass is composed of propylene glycol, vegetable glycerin, nicotine, and benign acids. The aromatic compounds, so widely demonized, are present in trace amounts, and their toxic potential is vastly lower than the well-documented harms of tobacco combustion.
"It’s not about denying risks — it’s about putting them into context. That’s what toxicological assessment does — and what alarmists refuse to do,” she stated.
But perhaps no one expressed the existential role of flavors more clearly than a consumer, a former smoker: “After I quit smoking, I got my sense of taste back. And I realized that the taste of tobacco was, in truth, the taste of death. It was the flavors — fruits, menthol, vanilla — that showed me there was another way to breathe.”
The diversity of flavors, argued Piotr Kozarewicz, an industry representative, is not a marketing whim; it's a strategy of inclusion. When regulators limit the options to one or two “safe” flavors, they effectively exclude entire groups of smokers who might switch to alternatives, but don’t identify with the taste of tobacco. To this, Autumn added a central provocation: “To stigmatize sensory pleasure in the process of quitting smoking is to dehumanize the subject.”
The session left a clear message: flavors matter — not in the moralistic sense suggested by many policies, but as functional tools. They are not traps for children. They are instruments for adults. They are choices. And, above all, they are proof that quitting smoking doesn't have to feel like punishment in order to be effective.
Dogma and Dissonance: The Moral Deadlock of Global Health
It was inevitable. At some point, the underground current of criticism that had run through so many previous sessions would eventually surface in full force. That moment occurred during the panel led by Clive Bates, which brought together notable figures such as Riccardo Polosa, Roberto Sussman, Thomas Nahde, Summer Hanna, and several audience members. The title was straightforward: “Evaluating the WHO’s Science on Harm Reduction.” What followed, however, was more than a technical assessment; it was a call for institutional accountability.
Clive Bates — a former director of ASH (Action on Smoking and Health) in the United Kingdom and one of the most respected strategists in public health policy — opened the discussion with the kind of unsettling clarity that comes from someone who has been inside the system and chose to step out.
“What the WHO practices today is not precaution — it is obstinacy.” According to Bates, the organization systematically refuses to engage with solid evidence on the benefits of reduced-risk products, instead opting for closed narratives centered on total abstinence, even when such a stance contradicts its own global epidemiological data.
Italian physician and researcher Riccardo Polosa was even more blunt:
“What the WHO is doing with science is clinical negligence. There is only one goal, in my view: to fabricate a science tailored to uphold the abstentionist narrative. But this has devastating consequences for millions of smokers who could switch to far less harmful products.”
Polosa denounced what he called a “tactical omission” on the part of the organization — selectively citing studies, excluding positive evidence about vapes and snus, and repeating vague phrases like “unsafe” or “ineffective” without offering any concrete comparative data.
Mexican physicist Roberto Sussman echoed the criticism with a bold and devastating argument:
“The WHO claims to be fighting Big Tobacco,” said Sussman, “but remains silent in the face of the largest tobacco company in the world — the Chinese state-owned enterprise. That is the real Big Tobacco.” For Sussman, the “war narrative” imposed by Article 5.3 of the Framework Convention on Tobacco Control, which asserts an irreconcilable conflict between public health and any product linked to the industry, has become a paralyzing dogma. A barrier that obstructs scientific and technological progress in the name of a manufactured moral purity.
Summer Hanna, bringing the industry’s perspective, reminded the audience that when the FCTC was first drafted, the WHO itself foresaw the transformative role that technological innovation could play in the lives of smokers. Harm reduction, she noted, was initially conceived as the third pillar of global tobacco control, alongside prevention and cessation, and this vision is explicitly embedded in the treaty’s own text. However, over the past two decades, the spirit of scientific curiosity and openness appears to have eroded.
Hanna also criticized the distorted use of IARC classifications (International Agency for Research on Cancer), which assess potential hazards rather than actual risks in everyday contexts. Applied uncritically, she argued, this logic could make everyday activities like eating grilled meat, using shampoo, or being exposed to sunlight appear as unacceptable threats. In her view, this confusion distorts public health discourse and undermines decisions that should be grounded in real-world evidence.
The audience, composed of researchers, health professionals, former smokers, and nicotine users, responded with heavy silences and restrained applause. There was less outrage than exhaustion. Because by then, the debate was no longer just about the inefficacy of WHO policies: it was about the human cost of ideological rigidity.
The panel concluded with a collective plea: for a reform of institutional science, for the opening of dialogue with consumers and independent scientists, and for the recognition of a truth as uncomfortable as it is urgent:
Nicotine is not the enemy. The enemy is combustion.
One Table, Neighboring Worlds
Following the harsh criticism of the World Health Organization’s stance on tobacco harm reduction, the debate at GFN25 did not spiral into resignation, but rather pivoted toward reconstruction. If the problem had been exposed with brutal clarity, the challenge now was to understand its roots and to imagine viable solutions. The tone, still critical, began to shift from denunciation to proposition.
The first step was to name the problem with precision. Participants once again highlighted the methodological flaws that have characterized scientific reviews conducted under the aegis of the Framework Convention on Tobacco Control: biased selection of sources, strategic omissions, and the deliberate distortion of evidence to uphold a narrative rooted exclusively in abstinence even when the data clearly point to viable, less harmful alternatives. Some even went so far as to suggest that this approach borders on willful negligence.
But why does it persist?
According to several panelists, the answer lies in the toxic combination of institutional inertia, political convenience, and a moralistic, outdated scientific orthodoxy. To admit the mistake, especially one rooted in decades of prohibitionist rhetoric, would mean acknowledging that lives were put at risk to protect a self-perpetuating structure. In an organization like the WHO, marked by rigid hierarchies and a low tolerance for external criticism, the prospect of internal rupture is viewed not as an opportunity but as a threat.
From there, the panel moved toward reform proposals — not utopian, but strategic and actionable:
Recenter the consumer: Understanding the practices and preferences of real nicotine users is essential for any scientific analysis that aspires to be both relevant and ethical.
Prioritize real-world data: Incorporating epidemiological evidence, biomarkers, and cohort studies can correct laboratory-driven distortions and provide a more accurate picture of the relative risks and benefits across products.oferecer um retrato mais fiel dos riscos e benefícios relativos entre produtos.
Place human stories at the center: Technical language must be accompanied by authentic narratives from those who quit smoking through vaping, from those ignored by authorities, from those who see harm reduction not as a concept, but as a lifeline.
Acknowledge evidence from regulated industry: Dismissing research produced by sectors operating under health regulation is a waste of knowledge, especially when the data can be independently audited.
Leverage market momentum: The growing consumer shift toward reduced-risk products can exert pressure on institutions like the WHO to abandon their normative isolation.
Foster cross-sector collaboration: Scientists, regulators, industry, and users must build a space of critical trust, where the legitimacy of dialogue stems not from ideological purity, but from a genuine willingness to listen.
What emerged, in the end, was not merely a catalogue of failures, but a map of possibilities. As several panelists reminded the audience, science does not progress through consensus, but through the courage to change one’s mind in the face of evidence. The challenge before the WHO is anything but trivial: to recognize that the abstinence-only paradigm is not neutral — it is exclusionary. And that any public health policy that ignores the plurality of human trajectories is doomed to save fewer lives than it could.
The afternoon closed with a direct yet composed call: the era of denial is over, and the responsibility for change already has a name, a face, and is long overdue.
A Brief Interlude of Resistance
On the second day of GFN25, as the weight of testimonies began to settle on shoulders and consciences alike, two fleeting, almost discreet moments disrupted the rhythm of the panels. They stood out as small acts of insubordination. Not found in slides. Nor in press releases. But in gestures.
The first came from a young vape shop owner from Indonesia who, at the end of a session on regulation in Asia, stood up and said: “I am not a scientist. I am not an activist. I just sold vapes to people who wanted to quit smoking. And I saw, one by one, their lives change.”
The simultaneous translation hesitated for a moment. But it didn’t matter. The room understood because what was spoken there was a language older than any policy: the language of shared experience.
The second moment came outside the auditorium. In a side corridor, someone discreetly taped a handwritten sign:
“To care is also to disobey.”
There was no logo, no signature. Just the phrase, and around it, throughout the day, small notes began to appear: anonymous testimonies from people who had quit smoking using illegal products, messages of support for persecuted scientists, confessions from consumers who had never been heard.
This brief interlude was not part of the official program. But, as so often happens, it was in that moment that the spirit of the forum revealed itself. Because to resist, in that space, was not merely to speak, it was to keep saying, even when there is no longer a place to be heard.
The second day of GFN25 did not end with answers. It ended with questions.
And perhaps that was its most radical gesture: in a world saturated with imposed certainties, making room for doubt is already an act of resistance. Through the corridors echoed an unsettling intuition: behind the graphs and statistics lie intentions; behind regulations, choices; and behind many prohibitions, the fear of losing control over bodies that dare to choose differently.
Between the first intervention of the morning and the final panel of the afternoon, what unfolded was a collective effort to return complexity to the debate, not as evasion, but as responsibility. Because to speak of nicotine is, ultimately, to talk about freedom: the freedom to breathe, to decide, to live better. And when that becomes controversial, perhaps it is the very concept of public health that needs to be reclaimed.
That’s how the second day came to a close with the conviction that scientific truth must not only be spoken, but translated. Not to be tamed, but to be understood where it truly matters: in the bodies that still smoke, in the faces no one consults, in the countries where silence costs lives.
Tomorrow, GFN25 would wake up to this task: to go beyond denunciation and finally imagine the future.
Between Fatigue and What Comes After
There was something different about the third day of GFN25. Perhaps it was exhaustion — not the kind that settles in the muscles, but the one that weighs on the conscience after hours of dense interventions, raw statistics, confrontations, and confessions. But there was also another kind of energy — quieter, deeper. It wasn’t euphoria. It was the steady strength of those who know they are right and, finally, know they are not alone.
That day did not begin with a grand closing keynote. It started with small voices, yet they overflowed with truth. Consumers. Shopkeepers. Young doctors. Experts who, outside the official panels, shared their stories in the hallways, at café corners, or during open-mic moments. A kind of knowledge that isn’t born in laboratories or peer-reviewed journals, but rises from bodies that suffer and endure—stories of smoke and resistance. Pain transformed into an argument. Data that bleeds.
More than a final day, it felt like a rite of transmission: the moment when technical knowledge merges with lived experience, and each testimony becomes, in its own way, a form of science. Not the science of controlled experiments, but the science of real-world impact. In public health, as repeatedly emphasized throughout the GFN, there is no such thing as neutrality: either a life is saved or an opportunity is lost.
Listening as a Technology of the Future: And it was precisely from that fatigue, not paralyzing, but ripened, that a new kind of listening emerged. No longer the cautious silence of the first day, nor the muffled exhaustion of the second. But the silence of those who know they must act. And know how.
As the panels took shape in the conference rooms and interpreters adjusted their headsets, something subtler, but no less decisive, was unfolding: listening had changed in texture. It was no longer the cautious silence of the first day, nor the muffled exhaustion of the second. It was a different kind of quiet. The kind that announces decisions. A form of attentiveness that does not wait for permission to act, but watches, in order to build.
In the corridors, at coffee tables, in improvised spaces where languages and life stories crossed paths, there was less indignation and more strategy. As if the forum, having named the wounds with such precision, had also awakened a shared desire to heal them.
The third day of GFN25 was no less dense. But it was different. It let go of denunciation as its dominant narrative and turned toward another urgency: reconstruction. Of language. Of policy. Of alliances. Instead of asking “Who failed?”, the question hung in the air like an ethical compass: “What must we build now, so we don’t fail again?”
Maria's Day
The gravitational center of the final day, however, had a name and a surname: Maria Papaioannoy-Duic.
Canadian, activist, former smoker, mother. For many, Maria is the living conscience of the global consumer movement defending safer alternatives to combustion. But she is more than that. Since the earliest editions of the GFN, her presence has not merely been that of someone advocating for a cause; it is the presence of someone who embodies its urgency. Maria did not speak only with her voice. She spoke with her biography. With her exhaustion. And with the lucid anger of someone who has lost too much to remain silent.
For years, Maria has stood not just as an advocate, but as a bearer of urgency: someone whose body and life story speak louder than the statistics and arguments she so rigorously upholds. And on that Saturday, when she took the stage, it wasn’t a speech she delivered. It was a reckoning.
Drawing from her lived experience, Maria exposed the widening chasm between what consumers are told and what they actually know, between official discourse and embodied truth. She described how, in Canada, regulatory contradictions have created an environment where misinformation doesn’t emerge from the fringes but from the center: it is born in institutional language, wrapped in the authority of government platforms, and reinforced by the dominant narrative.
She challenged the idea that misinformation begins on social media. It begins in parliaments, in official statements, in public health bulletins that, intentionally or not, blur the line between risk and danger, between abstinence and virtue.
Maria described the real-world consequences of these distortions: vape shop owners being fined or prosecuted simply for informing customers about harm reduction; approved products being withdrawn from the market without further scientific evaluation; and the absence of public education campaigns due to political pressure. And, above all, a health system in which the path to quitting smoking is more regulated and more stigmatized than smoking itself.
She didn’t name individuals, but she named the pattern: one in which policy is shaped less by science than by narrative control, where discomfort with complexity leads to sweeping bans that serve neither health nor equity.
Her tone wasn’t accusatory out of vanity — it was a defense of truth earned in the trenches of everyday life. At one point, she highlighted that tens of thousands of Canadians continue to die from smoking each year, even as reduced-risk products remain politically radioactive. The silence, she suggested, isn’t ignorance. It’s a strategy, and it’s lethal.
Maria closed not with slogans or catchphrases, but with something far rarer: a plea for moral clarity. For a science unafraid of complexity. For regulators who understand that withholding information also means withholding life.
And in that moment, surrounded by scientists, journalists, and fellow advocates, Maria’s voice became the voice of so many others excluded from the tables of public health, not for lack of evidence, but because their evidence lives in their lungs, in their losses, and in their refusal to vanish.
The Audience as Co-Author
When the microphone finally reached the audience after Maria Papaioannoy-Duic’s emotionally charged presentation, the session changed its very nature. It ceased to be a lecture and became a collective testimony. What followed was less a moment of questions and answers and more a shared reckoning: a communal act of memory and resistance, the kind that statistics rarely capture but lived experience refuses to forget.
One of the participants, grappling with the dilemma of public trust, posed a rhetorical, yet piercing, question: “What if it hadn’t been Dr. Konstantinos Farsalinos presenting this information, but someone like ‘Yanni the Vaper’ instead?”
The room understood instantly. In a world where truth competes with algorithms, credibility is not merely earned; it is curated, filtered. And expertise, no matter how rigorous, still demands translation in the face of disinformation's brutality.
Several participants returned to the battlefield of social media, where debates unfold in ten-second bursts and nuance is punished by the logic of attention. “If we’re long and complex, we’ll probably get deleted,” one voice observed, pointing to the challenge of communicating science within the click economy. Another participant added, with sober clarity: “We need to find better ways to use these platforms.”
But the frustration ran deeper. Someone asked, almost in lament, “What do we do when the other side doesn’t even want to be here?”
It wasn’t just about absence, it was about refusal. The kind of silence that speaks loudly because it is meticulously maintained. And that refusal to show up, to listen, to engage — is, in itself, a form of power.
The audience also raised questions about the invisible barriers keeping even sympathetic experts at the margins of the conversation: “The toxicity of this debate… many people are afraid their reputation will be damaged just for being seen at an event like this.”
The fear is real, not of the science, but of the association. Harm reduction linked to nicotine has become so politically charged that, as one participant pointed out, “the right often champions it, while the left embraces other forms of harm reduction. Doesn’t this make it harder to integrate these strategies into broader public health frameworks?”
And then, from the same place of exclusion, came ideas of inclusion. Someone proposed involving religious leaders in harm reduction efforts, particularly during observance periods like Ramadan, where offering safer alternatives to smoking could carry both cultural and clinical meaning. Another voice called for greater community representation and diversity, arguing that public policy cannot remain a closed circuit of experts and technocrats.
A clear consensus emerged: if the people directly affected by smoking are not part of the solution, they will remain victims of agendas that were never theirs.
Ultimately, it wasn’t an audience reacting to a speech. It was a room refusing passivity. Their words didn’t form an echo, but a response, a living counterpoint to years of decisions made without their participation. And in that space, even if only for a moment, the architecture of public health was turned inside out: those who had long been treated as objects of regulation claimed their place as co-authors of the conversation.
The Farewell That Pointed Forward
The Global Forum on Nicotine was born from the commitment of figures like Gerry Stimson and Paddy Costall, who understood — long before it became evident — that harm reduction is not just a health strategy, but an ethic of listening, inclusion, and resistance. Since its inception, the GFN has been that rare space where science, lived experience, and informed dissent coexist — not without tension, but with a common purpose: to save lives without sacrificing the dignity of those who live on the margins of traditional public policy.
This year, the forum reaffirmed its vocation: to provoke the necessary discomfort, allowing old certainties to be questioned and new questions to be finally asked. One of its central provocations, “Who else should be in the room?” — hovered like a moral compass over roundtables, debates, and corridor conversations. Because to speak of harm reduction today is to talk of real representation: not only of who gets to say, but of who is systematically prevented from being heard.
At the end of GFN25, there were no rhetorical promises, no grand symbolic gestures. What remained was a shared conviction: the future of public health will not be built solely by policy experts, but by those whose own bodies bear the marks of policies that have failed.
If harm reduction still provokes resistance, it is because it challenges the logic of control through fear. And precisely because of that, it remains a language of the future; one that insists on healing where once there was only punishment.
What Remains After the Silence
When the chairs are stacked, the halls swept, the badges tucked away, and the booths dismantled, what remains after an event like the Global Forum on Nicotine isn’t just the slides, the PDFs, or the executive summaries. What remains, what refuses to fade, is the discomfort. A specific kind of discomfort: the one born from the contrast between what is already known and what is still pretended not to be.
GFN25 ends as it began: with questions. However, they weigh more heavily now.
How many deaths are needed to revise a public policy?
When does an error cease to be ignorance and become a crime?
Who has the right to exist within the categories of “healthy citizen” and “responsible consumer”?
Harm Reduction as a Language of Resistance
The idea of harm reduction was never meant to be comfortable. And perhaps that is precisely why it endures. Because it carries within it the defiance of those who refuse the logic of abandonment. It wasn’t born in offices, but in the streets; not in technical manuals, but in bodies marked by use, by exclusion, and by the refusal to accept punishment as the only response to risk.
Applied to tobacco, the same unease returns. Harm reduction subverts decades of policies rooted in denial and blame. In their place, it proposes something disarmingly simple and profoundly human: smoking kills; there are far less harmful alternatives; denying access to them is a form of political violence: a violence that persists not out of accidental ignorance, but through deliberate choice.
At GFN25, this truth did not resound in bombastic declarations, but in the subtle weight of testimonies marked by loss, persistence, and lucidity. Doctors, scientists, consumers, dissident politicians, and vape shop owners were fined for informing others — all wove a quiet web of resistance, made of biography and science, of grief and unrest. A network invisible to bureaucracy, yet unmistakable in every story told.
In her address, Maria Papaioannoy-Duic did not raise her voice. But each word seemed to carry the resonance of long-standing silences. She wasn’t merely denouncing unjust laws or misguided decisions; she was indicting a system that, even when faced with the truth, chooses the more convenient lie. A system that turns ignorance into doctrine and cloaks it in the garments of authority.
For many in that room, the battle is not against tobacco. It is against institutionalized ignorance, the kind that hides behind polished ministerial speeches and regulations that strangle evidence in the name of a counterfeit morality.
Warsaw as Metaphor
It is no coincidence that the GFN takes place in Warsaw. Nothing in this city is incidental: every street, every shadow carries a memory that has resisted erasure. This is a city that knows the cost of silence. And perhaps that is why it remains the only place where a forum like GFN can exist without masks, without the pretense of neutrality.
Walking through Warsaw during the forum days is like crossing layers of contested time. Wars, treaties, pacts of obedience and rupture. Every corner whispers of crushed uprisings and improbable rebirths. The city does not forget. And it teaches, even unwillingly, that rebuilding requires more than concrete. It requires listening.
In this context, Warsaw is not just a backdrop. It is a character. A kind of architectural conscience observing the debates on public policy, harm reduction, freedom, and control. Nothing here is merely technical. Because when it comes to nicotine, what is at stake is not just a product; it is the right to live without being treated as a statistical nuisance.
GFN25 did not offer ready-made solutions. In an era of automatic formulas, it provided something far more precious: space. Space for questions that are usually silenced. Space for stories that politics would rather not hear. Space to remember that every life saved by quitting smoking is not an abstraction — it is a biography that continues, a body that breathes.
In practical terms, the forum sparked alliances, commitments, and blueprints for action. Representatives from countries such as Kenya, the Philippines, and Ukraine discussed joint strategies to pressure the WHO to adopt a more open stance on harm reduction. Scientists outlined an international coalition for independent research, free from institutional constraints. Consumers created transnational networks for information sharing and legal advocacy.
None of this will change the world overnight. But the seed was planted in yet another summer. And perhaps hope, in this historical moment, lies precisely in that radical and straightforward gesture: to give a name to what was previously just a number.
None of this will change the world overnight. But, as Summer Hanna reminded us, with clarity and conviction: “There may be many perspectives on the best way to address smoking, but it is in everyone’s interest to be part of the solution… And that is only possible through open dialogue, a robust scientific exchange that includes all viewpoints, and collaboration to truly end smoking.”
And perhaps hope, in this historical moment, lies precisely there: in the refusal to abandon complexity, and in the insistence that dialogue, even when uncomfortable, is what makes the future possible.
And Now?
As they left the hotel that June Saturday, the participants carried more than badges and notebooks. They carried the weight of knowing too much and the responsibility of not remaining silent.
GFN25 had come to an end, but its echoes continue to reverberate. In small shops across Canada, where speaking the truth can still be treated as a crime. In rural villages in India, modest devices quietly save lives, far from the spotlight. In the corridors of the WHO, where — if anyone is still truly listening — it may be time to acknowledge that the age of institutional arrogance has passed.
Because this is not just about products, regulations, or political frameworks.
It’s about something more elemental, more intimate: the right not to be punished for trying to live better.