Sweden's innovative tobacco control policies have made it a smoke-free leader. Explore how Trinidad and Tobago can apply these lessons to dramatically reduce smoking-related deaths in the region.

Breaking the Caribbean smoke ceiling with innovation and leadership

By Federico N Fernández

With just 100 days until the WHO Framework Convention on Tobacco Control’s 11th Conference of the Parties (COP11) convenes in Geneva, Caribbean nations face a defining moment.

While the Secretariat pushes a familiar narrative of prohibition and restriction, Trinidad and Tobago’s Prime Minister Kamla Persad-Bissessar has an unprecedented opportunity to exercise regional leadership by championing evidence-based innovation at the global stage.

The stakes could not be higher for Trinidad and Tobago.

With adult smoking prevalence at 19 percent 28.9 percent among men and 8.2 percent among women, the country faces a public health challenge that demands bold solutions. More sobering still, 5.4 percent of all deaths in Trinidad and Tobago stem from tobacco use, representing thousands of preventable tragedies annually.

The Swedish experience as guide for success

Sweden’s transformation offers important lessons for any nation serious about defeating smoking. While European Union (EU) countries struggle with average smoking rates of 24 percent, Sweden has achieved just 5.3 percent, positioning itself to become the EU’s first smoke-free member state 15 years ahead of schedule.

This was not achieved through wishful thinking or incremental measures. Sweden’s success rests on what research reveals as the “Triple-A Innovation” ensuring that innovative nicotine products are accessible, acceptable, and affordable for smokers seeking alternatives. The results speak volumes: compared to EU averages, Sweden reports 21.2 percent fewer smoking-related deaths, 36 percent fewer lung cancer deaths, and 31.3 percent fewer total cancer deaths.

Perhaps most telling is Sweden’s impact on European migrants. Those who move to Sweden see their smoking rates plummet to 7.8 percent, while their counterparts in their home countries maintain an average of 24 percent. This striking three-fold difference proves that Swedish policies work across cultural backgrounds, debunking claims that high smoking rates are culturally predetermined.

Innovation as ally, not enemy

The Swedish experience reveals distinct adoption patterns that should inform policy: 75 percent of male ex-smokers chose snus as their primary alternative, while over 50 percent of female ex-smokers preferred nicotine pouches. This gender-specific data underscores why product diversity and innovation accelerate progress toward smoke-free goals.

Critics often frame innovative nicotine products as threats to public health progress. Sweden’s data suggests the opposite: innovation renders cigarettes obsolete by providing superior alternatives.

Swedish research shows a near-perfect inverse correlation between oral nicotine product adoption and smoking decline as innovative product usage climbed from roughly 11 percent to 16 percent, daily smoking rates dropped from about 11 percent to 5.4 percent.

A Caribbean voice for evidence

Despite the Secretariat’s restrictive framing, many Parties at COP10 made thoughtful, evidence-based references to harm reduction and smokeless alternatives. New Zealand emphasised “evidence-based harm reduction measures”, including regulated vaping products. The Philippines highlighted a “balanced approach” and regulatory framework for vaporised nicotine products.

Notably, fellow Caribbean nation Saint Kitts and Nevis advocated for a Working Group on tobacco harm reduction, noting its value in other public health domains, while Guyana urged an “evidence-based discourse” on harm reduction, citing global examples. This creates an opening for Trinidad and Tobago to build on existing Caribbean support and lead regional efforts toward comprehensive approaches that combine traditional measures with innovation-friendly policies.

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The choice before Trinidad and Tobago

Prime Minister Persad-Bissessar faces the same choice Sweden confronted decades ago: continue along current trajectories with gradual progress, or embrace comprehensive approaches that harness innovation alongside traditional measures to accelerate the timeline while saving lives.

At COP11, the Prime Minister can position Trinidad and Tobago as a regional leader by advocating for evidence-based policies that acknowledge both the dangers of smoking and the reality that innovation can accelerate progress toward smoke-free status. With 5.4 percent of deaths in Trinidad and Tobago attributable to tobacco use, the stakes demand bold leadership that builds on existing Caribbean support from nations like Saint Kitts and Nevis and Guyana.

Sweden has demonstrated that comprehensive approaches combining traditional enforcement with innovation-friendly policies deliver results that seemed impossible just decades ago. The question now is whether Caribbean leadership will embrace this proven path or remain anchored to approaches that condemn the region to decades more of preventable death and suffering.

Federico N Fernández is a visionary leader dedicated to driving innovation and change. As the CEO of We Are Innovation, a global network of 50+ think tanks and NGOs, Federico champions innovative solutions worldwide. His expertise and passion for innovation have earned him recognition from prestigious publications such as The Economist, El País, Folha de São Paulo, and Newsweek. Federico has also delivered inspiring speeches and lectures across four continents, authored numerous scholarly articles, and co-edited several books on economics.

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