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Public Health and Trade: E‑cigarette Dispute

Lead Image
A man poses for a picture, as he vapes at home

Case Overview

U.S. trade promotion and global health priorities come into conflict when Guatemala places restrictions on the importation of a new U.S.-made flavored e‑cigarette product that it claims deliberately targets minors.

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The Situation

The United States has long been a leader in global health policy and has taken strides in recent decades to advance global tobacco control and prevent noncommunicable diseases at home and abroad. Yet prioritizing global health and tobacco control often comes at a cost to a country’s trade interests. Although the United States has placed limits on promoting the export of U.S. tobacco products, new products in the tobacco industry such as electronic cigarettes have brought on challenges in striking a balance between trade and global health priorities. With the use of e-cigarettes among adolescents rising globally, U.S. policymakers set up domestic regulations on flavored e‑cigarettes targeted toward minors but have yet to set clear foreign trade policy on the products. When a U.S. tobacco company complains that Guatemala is unfairly discriminating against the importation of its fruit-flavored e‑cigarette product, the United States needs to decide how to respond. The president has called a National Security Council (NSC) meeting to ask members to deliberate on a course of action. NSC members will need to balance U.S. trade and health priorities, weighing the interests of U.S. companies and their contributions to the U.S. economy against the United States’ commitment to global health and its leadership role abroad. 



  • Global health
  • Noncommunicable diseases
  • International trade
  • International tobacco control



  • U.S. economic interests
  • U.S. global health interests
  • Regulations on the trade and promotion of tobacco products
  • Regional free trade agreements in the Americas
  • Health risks of electronic cigarettes

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