Tobacco use remains a major public health concern in the Caribbean Region. There is no safe level of exposure to tobacco smoke. The use of tobacco products in any form harms nearly every organ of the body, irrespective of whether it is smoked, smokeless, or electronic. Of all the forms of tobacco use, most common in the Caribbean region is cigarette smoking. Cigarette smoking is the number one risk factor for lung cancer. Using other tobacco products such as cigars or pipes also increases the risk for this disease.
Second-hand smoke exposure causes stroke, lung cancer, and coronary heart disease in adults; and acute respiratory infections and severe asthma in children. It is a preventable risk factor for noncommunicable diseases (NCDs), which are the leading cause of death, disease and disability among Caribbean people.
This year, World No Tobacco Day focuses on Grow Food, Not Tobacco. This campaign advocates for ending tobacco cultivation and switching to more sustainable crops that improve food security and nutrition. The campaign observed annually on 31 May, also informs the public on the dangers of direct use, and exposure to tobacco.
In the Caribbean Region, non-communicable diseases (NCDs) are the leading cause of death and disability – 76.8% of the total deaths (non-Latin Caribbean, excluding Haiti) were due to NCDs in 2016. Cardiovascular diseases 30.8% and cancer 17.2% are the leading causes of death due to NCD, both linked to tobacco use. Many of these persons die in the prime of their lives before the age of 70 years old. The prevalence of smokers for overall tobacco products ranged from 57.2% prevalence (95%CI 48.4 to 65.4%) to 16.2% (95%CI 11.2 to 23.0%). According to the Report on Tobacco Control in the Region of the Americas (2018) Caribbean countries have the highest levels of tobacco experimentation before the age of 10.[1]
Dr. Joy St. John, Executive Director at the Caribbean Public Health Agency (CARPHA) “Smokeless does not mean harmless. Nicotine in e-cigarettes is a highly addictive drug and can damage children’s developing brains. Children and adolescents who use e-cigarettes at least double their chance of smoking cigarettes later in life. Preventing tobacco product use among youth is therefore critical. It is important that we educate children and adolescents about the harms of nicotine and tobacco product use. We must work to prevent future generations from seeing such products as “normal”.”
In 2008, the Caribbean Community (CARICOM) endorsed the recommendation to ban smoking in public spaces. Later, in 2012, CARICOM regulated a standard for labelling retail packages of tobacco products with health warnings. Caribbean civil society organizations (CSOs), working in collaboration with local governments and international partners, have led the charge in fighting for significant gains in tobacco control in the Caribbean region.
Dr Heather Armstrong, Head, Chronic Disease and Injury: “At CARPHA, we believe that reducing the harm caused by tobacco use requires a collective approach, where government, civil society, and the individual play a critical role. CARPHA promotes the prevention of tobacco use in all forms and commitment to the WHO FCTC. The focus on tobacco control deals with the youth of the Region. Children and adolescents who use e-cigarettes at least double their chance of smoking cigarettes later in life.”
The Chronic Diseases and Injury Department of CARPHA provides leadership, strategic direction, coordinates and implements technical cooperation activities directed towards the prevention and control of NCDs in CARPHA Member States. CARPHA’s message for prevention of tobacco product use has spread across its Member States.
In 2018, CARPHA in partnership with the University of the West Indies (UWI), Global Health Diplomacy Program at the University of Toronto, the Pan American Health Organization (PAHO), and the Healthy Caribbean Coalition evaluated the Port of Spain Declaration to learn which mandates helped to prevent and control NCDs. Taxation, smoke-free public places mandate, and mandatory labelling of tobacco products are some of the leading policies making the biggest impact on reduction of tobacco use in the Caribbean regions.
CARPHA urges Member States to work together to prevent and reduce the use of all forms of tobacco products, and scale-up efforts to implement their commitments under the WHO Framework Convention on Tobacco Control (FCTC). By doing so, the negative impact of smoking and its consequences on the health of our people, especially the younger generation, and the tremendous burden on the economies of the countries in our Region, will greatly be reduced.