Big Tobacco and Caribbean youth

By Dorial Quintyne

Why is the Caribbean suddenly the focus of lobbying by groups like the World Vapers’ Alliance, Smoke Free Sweden and We Are Innovation?

The answer is clear: our region is being targeted as an entry point for industry-driven narratives designed to weaken strong tobacco control ahead of the Conference Of The Parties ( COP11) to the World Health Organisation (WHO) Framework Convention On Tobacco Control.

The arguments presented in recent published articles and social media campaigns targeting Barbados and Trinidad and Tobago are not grounded in independent public health science. The latest piece even tried to characterise Trinidad and Tobago’s Ministry of Health data-collection efforts as supportive of a tobacco industry harm reduction agenda. They repeat the same talking points pushed by tobacco and related industries for years: that electronic cigarettes, nicotine pouches and heated tobacco products are “harm reduction” tools.

What they do not say is that these products are aggressively marketed to children and youth worldwide, that they are addictive and that their long-term health impacts remain uncertain.

Use of these products among adolescents is strongly linked to subsequent initiation of cigarette and other tobacco product use, with users having over three times the risk of starting cigarettes.

Nicotine is not harmless. It is highly addictive and linked to cardiovascular disease, cancers, and impaired brain development in children and adolescents. Electronic nicotine delivery systems often contain nicotine levels as high or higher than cigarettes.

Industry claims that these products are safer are not matched by independent research.

On its official web page, the World Health Organisation cautions that “the tobacco industry profits from destroying health and is using these newer products to get a seat at the policy-making table with governments to lobby against health policies. WHO is concerned that the tobacco industry funds and promotes false evidence to argue that these products reduce harm, while at the same time heavily promoting these products to children and non-smokers and continuing to sell billions of cigarettes”.

‘Not a genuine solution’

This warning underscores that these products are not part of a genuine public health solution, but rather another strategy for the industry to expand its markets and undermine effective tobacco control.

Dr Arthur Phillips, Deputy Chief Medical Officer in the Ministry of Health and Wellness, expressed concern about the Caribbean, especially Barbados, being targeted by these campaigns, noting: “As small island developing states, our limited health resources and high burden of non‑communicable diseases make us especially vulnerable to the long‑term costs of tobacco and nicotine addiction. Barbados has made significant progress in advancing tobacco control but these products are not without risk, particularly for our young people.”

In alignment with this warning, the National NCD Commission recently issued a response to these narratives, noting that while Barbados had made progress in reducing smoking rates through measures such as banning cigarettes in public places, the rise of vaping presents a new and serious threat. The commission emphasised that both nicotine and non-nicotine electronic delivery systems pose health risks, are aggressively marketed to youth with sweet flavours and bright packaging, and can fuel a new wave of addiction.

The Caribbean has worked hard to strengthen tobacco control. Our governments are parties to the WHO Framework Convention On Tobacco Control, which calls for protecting public health policies from the commercial interests of the tobacco industry. The “harm reduction” narrative promoted by the tobacco industry undermines this obligation by positioning industry-linked products as a solution. This is not tobacco cessation, it is profit-driven market expansion.

‘New tools of addiction’

Barbara McGaw, project manager at the Heart Foundation of Jamaica and Healthy Caribbean Coalition’s tobacco control advisor, cautioned that this is part of a broader industry playbook.

“Big Tobacco is shape-shifting into our culture, targeting our most vulnerable and selling harm disguised as a solution. We are losing another generation to these new tools of addiction. Caribbean governments must act now, applying the WHO’s MPOWER package with urgency to counter the spread of electronic nicotine and non-nicotine delivery systems,” she said.

Data on e-cigarette use in the region is limited but the 2018 Global Youth Tobacco Survey found current use of e-cigarettes among 13- to 15-year-old students ranging from four per cent in Antigua and Barbuda, 11 per cent in St Lucia, 11.7 per cent in Jamaica, and as high as 17.2 per cent in Trinidad and Tobago. Alarmingly, in Suriname, youth e-cigarette use grew from 5.9 per cent in 2016 to 8.8 per cent in 2022.

The call to action is urgent: Caribbean governments must go to COP11 united and vocal. We must defend strong, evidence-based tobacco control policies, reject industry interference, and push for global agreements that protect our populations from nicotine addiction in all its forms.

Dorial Quintyne, MPH, is a public health professional based in Barbados and a member of Healthy Caribbean Youth.