Health advocacy strategies to influence policy-making on and regulation of new and emerging tobacco and nicotine products in Latin America and the Caribbean.

Objective: To document health advocacy strategies to influence public policies regulating new and emerging tobacco and nicotine products in Latin America and the Caribbean. Methods: We analyzed public documents on new and emerging tobacco and nicotine products including news sources and national legislation and interviewed public health advocates in Latin America and the Caribbean. The policy dystopia model was used to assess health advocacy strategies for regulation of these products. Results: Legislative activity on these products mostly occurred in Argentina, Brazil, Chile, Costa Rica, Colombia, Mexico, and Panama. Health advocates engaged in four action-based strategies to influence regulation of these products - coalition management, information management, direct involvement in and access to the policy process, and litigation. Health advocates concentrated on exposing industry deception and providing scientific evidence and country experiences. Health advocacy argument-based strategies exposed the increased use of new and emerging tobacco and nicotine products due to aggressive industry marketing. Advocates argued governments should comply with the World Health Organization Framework Convention on Tobacco Control (WHO FCTC) obligations and its Conference of the Parties (COP) decisions to regulate these products. Conclusions: Applying the policy dystopia model on new and emerging tobacco and nicotine products provides a better understanding of how health advocates can pre-empt industry strategies to undermine WHO FCTC implementation. Unified transnational cooperative and coordinated health advocacy strategies to educate people can strengthen efforts. Promoting WHO FCTC obligations and COP decisions appears to support regulation on new and emerging tobacco and nicotine products and should be replicated elsewhere.