Background: This presentation will review the history of the introduction of tobacco to the three Pacific regions of Micronesia, Melanesia and Polynesia. Discussion: The earliest introduction of tobacco in the Pacific came with the Spanish trading and galleon travel to Saipan, Guam and other parts of Micronesia in the 17th century. Tobacco was introduced to Papua New Guinea shortly after through trading from Java and an early traveler to New Guinea said, “There is no single object of trade more useful to the traveler and trader in New Guinea than tobacco." Tobacco came later to Polynesia and it was introduced to Fiji only at the beginning of the 19th century. The presentation will review early examples of the way in which various people viewed tobacco. This will include a late 19th century study from Fiji conducted on the impact of smoking on pregnant women, possibly the earliest of this research in the world. The last Pacific country to have tobacco introduced were the islands of Kiribati, probably because of their isolation. Some examples of the way in which tobacco quickly became an item of trade and addiction will be provided. Conclusion: The presentation will conclude with a review of the relevance to current development of and support for effective tobacco control policy. This is of particular concern in relation to trade policy that will enhance future Pacific health.