Dorial Quintyne | It is not harm reduction; it is profiting from addiction

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 (COP) to the World Health Organization Framework Convention on Tobacco Control (WHO FCTC).

The arguments presented in recent published articles in NationNews, Barbados Today, News Americas Now, Fox44News and Trinidad and Tobago Guardian, and social media campaigns targeting Barbados and Trinidad 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 youths 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 ever-users having over three times the risk of starting cigarettes.

Nicotine 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 but independent research say otherwise.

The World Health Organization 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.” 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.

EXPERESSED CONCERN

Dr. Arthur Phillips, deputy chief medical officer in the Ministry of Health and Wellness, Barbados, 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 Barbados National NCD Commission recently issued a strong response to these narratives, noting that while Barbados has 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 youths 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 FCTC, 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.

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 shapeshifting 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.”

Data on e-cigarette use in the region are limited, but the 2018 Global Youth Tobacco Survey (GYTS) found current use of e-cigarettes among 13–15-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.

WAKE UP CALL

Dr Asante LeBlanc, former chairperson of Trinidad and Tobago Cancer Society, stated, “Rising youth e-cigarette use was a wake-up call. Protecting this generation from nicotine addiction is not just a campaign goal; it is a public health priority.”

The image used in the World Vapers’ Alliance article published August 11 particularly troubling. The article features a young black woman happily vaping, a moment that might look stylish or harmless at first glance. But behind the haze is an industry that has worked hard to make vaping appear trendy, masking the reality that these products can still deliver addictive nicotine and other harmful chemicals.

The image also reveals exactly who these products are marketed to, impressionable youths. It reflects a generation being enticed into lifelong nicotine addiction by companies that profit from our health and our futures.

Caribbean governments must go to COP 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. We must champion measures that we know work: higher tobacco taxes, bans on advertising, strong smoke-free laws, graphic health warnings, and accessible cessation services.

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