Youth Tobacco Addiction: The Silent Epidemic Stealing Futures

I was walking through the narrow alleys of Basantapur, one of the most vibrant, culturally rich, and historic areas of Kathmandu, Nepal, when my eyes caught a disturbing scene: a group of boys, no older than 14, sharing a single cigarette. Their faces still soft with youth, yet their actions spoke of an addiction already taking root. This wasn’t just a puff of smoke but a fog settling over their futures.

The Alarming Reality of Youth Tobacco Addiction

This practice isn’t isolated. Across Nepal, adolescents are falling prey to tobacco addiction at alarming rates. A 2019 survey revealed that 28% of Nepalis aged 15-69 use tobacco. In 2020, 68 out of 2,800 hospitalized cases of E-cigarette or Vaping Use-Associated Lung Injury (EVALI) were under 18 years old. Despite laws prohibiting minors from buying tobacco, access remains shockingly easy.

Those boys should’ve been chasing dreams, not cigarettes. Yet, there they were: tobacco already gripping their health, ambitions, and hope. What alarmed me most wasn’t the act itself, but their casual acceptance. No guilt, only confidence. They saw smoking as a regular part of growing up.

But this is just the tip of the iceberg. Beneath lies a more profound crisis: misinformation, peer pressure, familial habits, and aggressive tobacco industry marketing.

How Big Tobacco Targets the Young Generation

Globally, over 17% of youth use tobacco, including 37 million children aged 13-15 (Global Tobacco Youth Survey Report). The industry thrives by hooking young users early, ensuring lifelong customers. Their tactics?

• Flavored products that appeal to teens
• Social media glamorization from TikTok, Instagram, and YouTube challenges
• Stealth marketing by sponsoring music festivals and fashion shows
• Disguised e-cigarettes, designed like USB drives, pens

Research by the U.S. Surgeon General (2012) confirms that adolescents are more likely to get addicted, with many struggling to quit for life. Worse, e-cigarette use quadruples the chance of transitioning to traditional cigarettes (National Academies of Sciences, 2018).

A Sister’s Fear: Will My Brothers Be Next?

As a sister to two teenage brothers, my fear is constant. I instinctively check for smoke whenever they return from school or a walk. It’s not the best approach, but it’s my way of protecting them.

Recently, I visited my old school, Janapremi World School, Bhaktapur, not as a student, but as a public health advocate conducting anti-tobacco awareness sessions. Standing before those bright faces, I remembered friends who started smoking, lost their way, and dropped out. Schools lost scholars. Society lost its future.

When I asked students if they knew about vaping, hookahs, or e-cigarettes, every hand went up. Many even explained how “vaping isn’t smoking,” some with parents who mistakenly believe it’s harmless.

Breaking the Cycle: Awareness, Education, Action

This generation is inheriting myths. It’s our duty to debunk them. The only solution? Awareness, education, and action.

Since February 2025, Nepal Health Corps (NHC)—a youth-led organization—has been running a Nationwide Anti-Tobacco Campaign in collaboration with the World Federation of Public Health Associations (WFPHA). With WHO’s powerful message, “Be smart, don’t start,” we’re educating Grades 6-12 students on the dangers of smoking, vaping, and smokeless tobacco.

How the Campaign Works:

• Interactive sessions on tobacco’s health effects
• Peer-led advocacy from trained nursing/medical students
• Social media engagement using custom posters and awareness drives
• Data collection on youth tobacco trends

Phase 1 (Feb–July 2025) aims to reach 10,000+ students. Schools welcome us, one teacher admitted, “We just caught two students smoking yesterday. This education is missing in curricula.”

The Power of Prevention: Let’s Make Tobacco Uncool

Smoke-free spaces aren’t just about bans, they’re about shifting perceptions. Through media, storytelling, and youth mobilization, we’re making tobacco irrelevant, uncool, and unwanted.

Join the Fight Against Youth Tobacco Addiction

• Share real stories.
• Educate the next generation.
• Support anti-tobacco campaigns.

Together, we can clear the fog and give youth back their futures.

Youth Power: The Next Generation’s Role in Lifelong Immunization

Today’s youth represent not just the future of healthcare but a powerful force for change. Their digital fluency, innovative thinking, and peer influence make them uniquely positioned to advance life-course immunization in ways traditional approaches cannot.

To appreciate their impact, consider how young professionals are already driving change.

Innovative Approaches to Vaccine Advocacy

Young healthcare students and professionals are revolutionizing immunization efforts through creative strategies. Medical students develop peer education programs that resonate with younger audiences. Pharmacy students bring vaccines to underserved communities. Digital natives create social media campaigns that effectively counter misinformation.

These approaches are particularly effective in addressing long-standing challenges.

Tackling Tough Challenges Head-On

Youth-led initiatives are making remarkable progress, whereas traditional methods have struggled. They’re breaking down cultural barriers to HPV vaccination through community dialogues, increasing access in remote areas through mobile clinics, and, perhaps most importantly, rebuilding trust in vaccines through relatable, peer-to-peer communication.

Their success offers valuable lessons for the broader healthcare community.

What the Establishment Can Learn

The youth movement exemplifies several key principles that can enhance all immunization efforts. Authentic storytelling often proves more persuasive than data alone. Meeting people where they are (physically and digitally) increases engagement. Empowering local champions builds sustainable change.

Supporting these young leaders should be a priority for health organizations.

How to Foster Youth Leadership

Investing in young vaccine advocates yields tremendous returns. This includes:

• Creating funding opportunities for student-led initiatives
• Establishing youth advisory councils
• Incorporating immunization leadership training into health education curricula.
  

The energy and innovation of young healthcare professionals represent our best hope for achieving life-course immunization for all. By empowering today’s youth, we secure healthier communities for generations to come.

Click here to read the original Final Call to Action as signed and supported by multiple international NGOs.

Bridging Public Health and Global Policy: A Conversation with Emeka Iloegbu 

Public health is more than just medicine and science. It’s about people, policy, and the bridges we build between them. In this insightful interview, Bettina Borisch, CEO of the World Federation of Public Health Associations (WFPHA), sits down with Emeka Iloegbu, a dedicated public health leader, educator, and advocate. From his early days as an intern at WFPHA to his current roles in global health policy and laboratory epidemiology, Emeka shares his journey, the challenges of global health governance, and the importance of passion in driving meaningful change.  

Their conversation covers the transformative potential of the Pandemic Treaty, the critical role of diagnostics in public health, and the geopolitical challenges facing global health today. Emeka’s optimism and commitment to equity, accountability, and community-driven solutions offer a refreshing perspective on how we can collectively shape a healthier future.  

From Intern to Global Health Leader: Emeka’s Journey  

Bettina Borisch: Hello, everyone! My name is Bettina Borisch, CEO of the World Federation of Public Health Associations. Today, I have the pleasure of speaking with Emeka Iloegbu, a long-standing pillar of our federation. Emeka, could you introduce yourself?  

Emeka Iloegbu: Absolutely. First, I’d like to thank you, Bettina, and the WFPHA for this opportunity. My name is Emeka Iloegbu. I’m an assistant program director and professor at the City University of New York in a laboratory science program. I’m also a laboratory epidemiologist and microbiologist, working in various labs during multiple health emergencies.  

I represent WFPHA in several capacities, including at the United Nations headquarters in New York. I serve on the Global Health Policy Task Force and co-chair the Public Health in Emergencies and Disasters Working Group. Additionally, I’m engaged in fieldwork with Geneva-based organizations like Market Access Africa. I’m thrilled to be here and dive into this conversation.  

Bettina: Listening to you, one might wonder how you managed all this simultaneously! It must have started somewhere. Where did your journey with WFPHA begin? I remember you were an intern with us years ago. How was your first day?  

Emeka: The memories are flooding back! My public health journey has two trajectories, and it started with my mom. When she came to the U.S. from Nigeria, her first job was as a public health nurse. As a kid, I’d sit in the car watching her go door-to-door with surveys, not fully understanding what she was doing, but that planted a seed.  

Fast forward to 2017: I was in my second year of my MPH at Mount Sinai Icahn School of Medicine, working an overnight shift in a hematology lab at NYU. I wanted to understand global health policy, so I Googled and found WFPHA. I sent an email with my CV, and soon enough, I was in Geneva.  

My first day was an adventure—arriving without a proper SIM card and navigating from the airport to Plan Palais at 8:30 PM. But stepping into Campus Biotech was amazing. Those three months as an intern were transformative. I was eager to learn, meet people, and even walk into UNHCR out of curiosity. That energy and passion have only grown since.  

Bettina: You attended the World Health Assembly (WHA), your first immersion into global health diplomacy. What was that like?  

Emeka: It was a sight to behold. Seeing 194 countries, civil society organizations, and advocates in one place, my worldview expanded. I sat in the upper deck with medical and pharmacy students, some of whom I’m still connected to today. There was live music, a symphony, and it felt like a celebration. That experience reshaped how I saw global health.  

The Pandemic Treaty and Global Health Governance  

Bettina: Now, you’re deeply involved in the Pandemic Treaty negotiations. What are your thoughts on its potential impact?  

Emeka: The treaty could transform global health governance by introducing legally binding norms on preparedness, data sharing, and equitable access to countermeasures. Our task force focuses on embedding equity, accountability, and local ownership into the treaty. We advocate for:  

– Inclusive decision-making (civil society, public health associations, community voices).  

– Sustainable financing for health systems.  

– Technology transfer and capacity-building.  

The challenge is bridging the trust gap between high-income and lower-income countries. High-income nations prioritize sovereignty and intellectual property protection, while others emphasize solidarity and justice. Without equitable implementation, the treaty risks becoming just another document.  

Bettina: Your role extends beyond the treaty. You guide WFPHA members through the UN system in New York.  

Emeka: Yes! Whether it’s TB, mental health, or NCDs, our task force applies a systems-thinking lens. We assess complex issues, offer nuanced insights, and support member associations in advocacy. It’s about ensuring diverse voices shape global health policies.  

The Lab and Public Health: An Overlooked Bridge  

Bettina: We both have a soft spot for lab work. How do you see diagnostics fitting into public health?  

Emeka: The lab is the frontline of pandemic detection. Without timely, accurate diagnostics, surveillance collapses. My fieldwork in Zambia highlights the need for universal access to diagnostics, especially for mobile and vulnerable populations.  

Now, with AI and machine learning revolutionizing diagnostics (like automated HIV testing), we must ensure these innovations reach everyone, not just high-income countries.  

Global Health Challenges: Optimism Amidst Crisis  

Bettina: Global health faces immense challenges, including climate change, AMR, and geopolitical tensions. How do you stay hopeful?  

Emeka: I’m a glass-half-full person. Yes, we face climate-driven health crises, AMR, and inequities, but we’re also seeing progress. Decolonization conversations are growing, and young professionals are stepping up, like at the UN General Assembly last year.  

My message? Don’t ignore your passion. In a world of challenges, let your drive for change guide you.  

Conclusion

Emeka Iloegbu’s journey, from watching his mother’s public health work to shaping global policy, highlights the power of passion and persistence. His insights remind us that public health is not just about science but about people, equity, and bold systemic change.  

As the world prepares for the WHA’s vote on the Pandemic Treaty, Emeka’s work underscores a critical truth: global health is a collective responsibility. Whether in labs, policy rooms, or communities, each of us has a role in building a healthier, fairer future.  

To the next generation of public health leaders: Follow your passion, embrace challenges, and keep pushing forward. The fight for equity and health justice is far from over, but with voices like Emeka’s leading the way, the path ahead is brighter.  

2024-2025 Annual Report Is Now Available!

Our 2024-2025 Annual Report is now available for viewing. This report showcases WFPHA’s key initiatives and activities aimed at protecting people, preventing diseases, and promoting global health and well-being.

Nicotine Poses a Serious Threat to Public Health: Why it Needs Strict UN Control

Nicotine, the addictive substance in tobacco, is a growing public health crisis. With the rise of e-cigarettes, nicotine pouches, and flavored products targeting children, urgent action is needed. Dr. David Chalom, a senior consultant in orthopedic surgery, argues that nicotine must be reviewed by the World Health Organization (WHO) and placed under strict international control by the UN to protect future generations.  

The Dangers of Tobacco and Nicotine

1. Tobacco: A leading cause of preventable death  

Tobacco is the leading cause of non-communicable diseases worldwide. Two-thirds of long-term smokers die from smoking-related illnesses. Unfortunately, tobacco use persists because of nicotine addiction.

2. Nicotine: A potent neurotoxin and highly addictive drug

Originally used as an insecticide, nicotine is toxic to humans. It’s also more addictive than cocaine and amphetamines, leading to lifelong dependency. Other issues with nicotine include:

– Impairing brain development in youth (up to age 25), increasing risks of: 

       – Mental health disorders  

       – Addiction to other drugs (alcohol, narcotics)  

       – Poor cognitive function 

– Damaging blood vessels, reducing oxygen supply to organs, leading to

        – Increased risk of stroke and heart disease  

        – Poor healing and tissue degeneration

– Harming fertility, pregnancy, and infants, increasing risks of:

          – Miscarriage  

          – Low birth weight  

          – Sudden Infant Death Syndrome (SIDS)  

The Rise of New Nicotine Products Targeting Youth

The tobacco industry exploits regulatory loopholes by introducing flavored nicotine products designed to attract children:  

– E-cigarettes (vapes)  

– Nicotine pouches (“white snus”)  

– Nicotine candies (jelly beans, gummies, lollipops)  

– Lip balms, mints, and Tic-Tacs laced with nicotine  

Alarming Trends in Sweden (2012-2024 Data)

The Swedish Council for Information on Alcohol and Other Drugs (C.A.N.) did a nationwide school investigation between 2012 and 2024 on 9th graders and 2nd-year high schoolers. It found that 9th graders and high school students are increasingly using:

  – E-cigarettes  

  – Nicotine pouches  

  – Snus

All of this is problematic. While these youths are considered “non-smoking,” they become addicted to nicotine, later transitioning to cigarettes.  

What Experts and International Conventions Say

1. European Respiratory Society (ERS)

No evidence supports claims that nicotine products help smokers quit. Most e-cigarette users continue smoking traditional cigarettes. Thus, nicotine remains harmful and addictive.  

2. WHO Framework Convention on Tobacco Control (FCTC)  

Governments must work to:  

– Eliminate tobacco and nicotine use  

– Protect children from addiction  

– Reduce secondhand smoke exposure  

3. UN Conventions
   

Consider two UN Conventions: the UN Single Convention on Narcotic Drugs (1961/1972) and the UN Convention on Psychotropic Substances (1971). These treaties allow scheduling substances that pose serious public health risks.  

Why Nicotine Must Be Reviewed by the WHO and Controlled by the UN

Nicotine meets all criteria for strict international control: 

– Highly addictive  

– Widely abused, especially by youth  

– Minimal therapeutic value

– Serious public health threat  

Call to Action: Steps Toward a Nicotine-Free Generation by 2030

Nicotine isn’t just an addiction; it’s a public health emergency. With flavored products targeting children and the rising outh addiction rates, immediate action is needed. The WHO must review nicotine, and the UN must impose strict controls to protect future generations.

Yet, from the individual to the state level, everyone has a role to play:

– Governments: Notify the UN Secretary-General to review nicotine.  

– NGOs & Health Organizations: Petition the WHO to assess nicotine’s risks.  

– Public Awareness: Get educated on nicotine’s dangers, especially for youth.  

Together, we can all work towards a nicotine-free generation by 2023.

Do you have questions for David? Then don’t hesitate to write him at david.chalom.a@gmail.com

Reimagining Global Health Strategies: Reinforcing Gender Equity in Dentistry for a Healthier Future

Reimagining global health strategies requires confronting persistent inequities that shape health outcomes, particularly in dentistry and gender equity. Gender equity is not only a fundamental human right but also a strategic imperative for improving population health, strengthening health systems, and achieving sustainable development. Yet, in fields such as dentistry, gender equity remains overshadowed by longstanding structural and cultural norms.

According to the Canadian Encyclopedia, gender equity in healthcare refers to treating individuals according to their unique needs and contexts, considering how power and privilege affect opportunity. This principle is tied to the core value of fairness and is critical to building inclusive, ethical, and sustainable systems that reflect the diversity of health providers and their communities. Harmful gender stereotypes, alongside racism, ageism, and socioeconomic inequities, compound existing barriers to oral healthcare access and professional advancement for women and gender-diverse individuals. 

Why Gender Equity Matters in Dentistry

Neglecting gender equity in dentistry perpetuates significant inequities across research, clinical practice, and leadership. Despite progress in gender diversity in dental schools, systemic transformation remains elusive. Structural barriers and cultural norms continue to shape career trajectories, specialization choices, and professional development. 

• Access to equitable oral health care: Women and gender-diverse individuals face unique challenges in accessing oral healthcare, shaped by systemic, social, economic, and personal barriers. Poor maternal oral health extends beyond mothers, significantly affecting children’s well-being. Additionally, gender-diverse individuals remain underrepresented in digital innovations like virtual oral healthcare, which exacerbates existing disparities in quality healthcare access.
  
  
• Education and gender myths in dentistry: Though more women enter dental programs, a persistent gender equity myth falsely assumes that inclusivity has already been achieved. Invisible gender-based discrimination often goes unaddressed, leaving affected individuals isolated without institutional support.
  
• Clinical practice and workplace culture: Masculinist work cultures, sexism, harassment, and gender stereotypes remain a reality in dentistry, impacting job satisfaction and career advancement for women and gender-diverse individuals. These barriers contribute to vertical and horizontal segregation in dentistry.
  
• Research disparities: Women face significant gaps in authorship, funding access, and scientific recognition. Men dominate highly cited publications and editorial boards, perpetuating systemic barriers in dental research equity.
  
  
• Glass ceiling in dental leadership: Outdated gender norms and patriarchal structures limit leadership opportunities. Men disproportionately hold high-ranking academic roles (e.g., deans, department heads). At the same time, women remain often overrepresented in lower-ranking faculty positions, which are exacerbated by unequal pay and exclusion from decision-making.

Global challenges such as population aging, COVID-19, and climate change demand that dental health strategies be reimaged through a gender-equity lens, promoting sustainable and inclusive oral healthcare systems.

Pathways to Achieve Gender Equity in Dentistry

Addressing gender equity challenges in dentistry requires coordinated systemic efforts to restructure the profession. A gender-equitable future fosters better care, innovation, and responsive systems.

1. Structural Change & Policy Reform

• Collect and publish gender-disaggregated data to inform policy and clinical decision-making.
• Evaluate DEIAB (Diversity, Equity, Inclusion, Accessibility and Belonging) initiatives regularly.
• Diversify career advancement and promotion criteria.

2. Mentorship & Leadership Development

• Establish mentorship programs for women and gender-diverse professionals.
• Create leadership training for underrepresented groups.
• Showcase diverse role models to inspire the next generation.

3. Inclusive Education & Clinical Training

• Integrate gender equity and intersectionality into dental curricula.
• Train faculty and students to address gender-specific oral health needs.
• Promote inclusive, patient-centered clinical practices.
  

4. Gender-Inclusive Innovation & Sustainability

• Ensure equitable access to digital dentistry tools.
• Include gender-diverse perspectives in healthcare innovation.
• Embed gender equity in sustainable dentistry, acknowledging climate change’s disproportionate impact on women in low-resource settings.

A Call to Action: Building an Equitable Future in Dentistry

Gender equity in dentistry is more than a matter of fairness. It is necessary for building a healthier, more inclusive, and resilient profession. Aligning efforts with the 2030 Agenda for Sustainable Development can advance social justice. Achieving equity requires collective action from institutions, policymakers, educators, and providers. By dismantling structural discrimination and fostering inclusivity, we can close the gender gap and ensure that all individuals, regardless of gender or background, thrive in dental education, practice, and leadership.

Dr. Pascaline Kengne Talla wrote this article on behalf of the WFPHA’s Oral Health Working Group