Last week, the World Health Or­ga­ni­za­tion’s flag­ship to­bac­co con­trol con­fer­ence, COP11, took place in Gene­va. It was meant to be a defin­ing mo­ment in the glob­al cam­paign against nico­tine. In­stead, it be­came a mo­ment of reck­on­ing.

Rather than so­lid­i­fy­ing glob­al sup­port for bans on va­p­ing and oth­er re­duced-risk prod­ucts, the WHO was met with grow­ing re­sis­tance. A di­verse group of coun­tries, in­clud­ing Saint Kitts and Nevis, New Zealand, Ser­bia, Mozam­bique, and Gam­bia, stood up and de­mand­ed a shift: from ide­o­log­i­cal re­stric­tions to ev­i­dence-based, flex­i­ble reg­u­la­tion that re­spects na­tion­al re­al­i­ties.

For years, the WHO and its net­work of donor-backed NGOs have fought to po­si­tion harm re­duc­tion as a threat rather than a so­lu­tion. De­spite over­whelm­ing ev­i­dence from coun­tries like Swe­den, where smok­ing rates are be­low 6% thanks to prod­ucts like va­p­ing and nico­tine pouch­es, the WHO dou­bled down on ab­sti­nence-on­ly mes­sag­ing.

But this year, the nar­ra­tive cracked. In­stead of push­ing through rec­om­men­da­tions for bans as ex­pect­ed, COP11 end­ed with wa­tered-down, non-bind­ing lan­guage. All mea­sures re­lat­ed to va­p­ing and sim­i­lar prod­ucts were post­poned un­til the next meet­ing in two years due to the re­sis­tance of these coun­tries.

St. Kitts and Nevis emerged as one of the lead­ing voic­es, de­liv­er­ing one of the strongest state­ments of the week, which called for harm re­duc­tion to be recog­nised as a le­git­i­mate pub­lic health strat­e­gy and urged del­e­gates to dif­fer­en­ti­ate sci­ence from ide­ol­o­gy. Their call res­onat­ed wide­ly, gain­ing sup­port across del­e­ga­tions.

This shift mat­ters for Trinidad & To­ba­go, which is cur­rent­ly re­assess­ing its own ap­proach to reg­u­lat­ing less harm­ful nico­tine al­ter­na­tives. The coun­try now has the op­por­tu­ni­ty to choose sci­ence over fear and lead the Caribbean in­to a new era of pub­lic health, along with St. Kitts and Nevis.

Lessons for Trinidad & To­ba­go

Thou­sands of Trinida­di­ans still smoke, and cig­a­rettes con­tin­ue to claim lives. The rise of va­p­ing and oth­er less harm­ful al­ter­na­tives of­fers a re­al op­por­tu­ni­ty to change that, but on­ly if reg­u­lat­ed pro­por­tion­ate­ly to their rel­a­tive risk pro­files.

Min­is­ter of Health Ter­rence Deyals­ingh re­cent­ly ac­knowl­edged the need for up­dat­ed leg­is­la­tion and com­mit­ted to a da­ta-gath­er­ing phase on nico­tine prod­ucts. This is a good first step, but this must go fur­ther. The gov­ern­ment must rec­og­nize the sci­en­tif­ic facts that va­p­ing, nico­tine pouch­es and heat­ed to­bac­co prod­ucts are vast­ly less harm­ful than smok­ing. Con­se­quent­ly, these prod­ucts re­quire dis­tinct reg­u­la­tions and should not be treat­ed as cig­a­rettes. Re­duced harm should trans­late in­to low­er tax­es and more pro­por­tion­ate rules.

One of the most com­pelling lessons from COP11 is that Caribbean coun­tries don’t need to fol­low the script writ­ten in Gene­va. St. Kitts and Nevis showed that small na­tions can speak bold­ly and be heard. Trinidad & To­ba­go should join them.

To­geth­er, the re­gion can push for a frame­work that sup­ports smok­ers in switch­ing to less harm­ful al­ter­na­tives, re­duces health in­equal­i­ties, and pro­motes trans­paren­cy in pub­lic health pol­i­cy­mak­ing. We can­not af­ford to let this mo­ment pass us by.