Barbados stands at the cusp of making history. With smoking rates at just 6.4% of adults, the nation has achieved the lowest smoking prevalence in the Caribbean region. Yet despite this success, thousands of Barbadian lives remain at risk, and the path to becoming truly smoke-free lies within the nation’s grasp.
Recent analysis from international health experts at “Smoke Free Sweden” reveals a stark reality: more than 14 million lives can be saved globally by 2060 if governments act decisively to integrate tobacco harm reduction into traditional control methods. For Barbados, this represents an unprecedented opportunity to become the Caribbean’s first smoke-free nation by embracing less harmful nicotine alternatives like vapes and oral nicotine pouches.
The evidence supporting harm reduction is compelling. In the United Kingdom, smoking rates fell by 41% as vaping became a popular alternative. Japan saw cigarette sales plummet by more than 40% following the introduction of heated tobacco products. Most remarkably, Sweden has become the world’s first officially smoke-free nation, with just 4.5% of Swedish-born adults smoking, achieving smoking-related death rates that are the lowest in the European Union.
Dr Delon Human, leader of Smoke Free Sweden and former secretary general of the World Medical Association, puts it plainly: “Policymakers face a clear choice: lead a public health revolution or fail their citizens.” The strategies to make smoking obsolete by making less harmful alternatives accessible, affordable and acceptable are proven.
For Barbados, the numbers are encouraging. With 11% of men still smoking, targeted harm reduction policies could drive these numbers below the 5% threshold that defines a smoke-free society. The gender gap in the smoking rates, where only 1.7% of women smoke compared to 11.7% of men, suggests that tailored approaches focusing on male smokers could yield dramatic results.
However, Barbados faces a critical challenge at the upcoming 11th Conference of the Parties to the WHO Framework Convention on Tobacco Control in Geneva this November. The WHO has consistently promoted prohibitionist approaches that deny smokers access to products that are 95% less harmful than cigarettes. This ideological stance effectively protects the cigarette trade by limiting access to less harmful alternatives.
The WHO’s preliminary agenda for COP11 reveals a troubling bias, referring to harm reduction as merely the “tobacco industry’s narrative” and framing the entire discussion defensively rather than engaging with the mounting scientific evidence. This approach ignores the fundamental truth that people smoke for the nicotine but die from the tar in cigarettes.
Barbados must join other forward-thinking nations in pushing back against this outdated approach. At COP10, several countries, including New Zealand, the Philippines, and Saint Kitts and Nevis, made constructive, evidence-based comments supporting harm reduction. Saint Kitts and Nevis even proposed establishing a Working Group dedicated to tobacco harm reduction, though this proposal has been conspicuously absent from the COP11 agenda.
A look at Barbados’ neighbours in Trinidad and Tobago shows that they face an even starker reality, with nearly 30% of men smoking. Regional cooperation on harm reduction policies could save thousands of lives across the Caribbean while establishing the region as a global leader in pragmatic public health approaches.
The upcoming COP11 conference presents Barbados with a platform to champion science over ideology. The national delegation must advocate for transparent, evidence-based tobacco control measures that include harm reduction strategies. By doing so, Barbados can lead not just the Caribbean but serve as a model for smaller nations worldwide.
The evidence is clear, the tools are available, and the potential for saving lives is immense. Barbados must act decisively at COP11 to ensure that public health, not prohibitionist ideology, guides global tobacco control policy. The citizens deserve nothing less than the most effective, science-based approaches to ending smoking once and for all.
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