Past evidence suggests that economic globalization and the spread of neo-liberal policies are leading to higher adult smoking rates in the developing world, but currently there are no cross-national analyses examining the impact of economic globalization and neo-liberal policies on youth smoking rates in the developing world. This study seeks to fill the gap in the literature regarding youth smoking and neo-liberal policies by conducting the first cross-national panel analysis of youth smoking rates in the developing world. Using data from the Global Youth Tobacco Survey (GYTS), the World Bank, Freedom House, and United Nations for over 90 nations, this study expands the use of dependency theory to test for the negative externalities of neo-liberal trade and investment policies on health. Specifically, this study examines the relationship between increasing international trade, multinational corporate penetration, and membership in the International Tobacco Growers Association (ITGA) on youth smoking rates in developing nations using first difference scores. The results show support for the hypothesis that increasing international trade dependency and membership in the ITGA are correlated with increasing youth smoking rates in the developing world.