scholarly journals Needs of LMIC-based tobacco control advocates to counter tobacco industry policy interference: insights from semi-structured interviews

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e044710
Author(s):  
Britta Katharina Matthes ◽  
Lindsay Robertson ◽  
Anna B Gilmore
Keyword(s):  
Tobacco Control ◽  
Structural Changes ◽  
Tobacco Industry ◽  
Control Policy ◽  
Qualitative Description ◽  
Structured Interviews ◽  
Middle Income ◽  
Adoption And Implementation ◽  
National Coalition ◽  
Industry Policy

IntroductionAdvocacy is vital for advancing tobacco control and there has been considerable investment in this area. While much is known about tobacco industry interference (TII), there is little research on advocates’ efforts in countering TII and what they need to succeed. We sought to examine this and focused on low- and middle-income countries (LMICs) where adoption and implementation of the Framework Convention on Tobacco Control (FCTC) tend to remain slower and weaker.MethodWe interviewed 22 advocates from eight LMICs with recent progress in a tobacco control policy. We explored participants’ experiences in countering TII, including the activities they undertake, challenges they encounter and how their efforts could be enhanced. We used Qualitative Description to analyse transcripts and validated findings through participant feedback.ResultsWe identified four main areas of countering activities: (1) generating and compiling data and evidence, (2) accessing policymakers and restricting industry access, (3) working with media and (4) engaging in a national coalition. Each area was linked to challenges, including (1) lack of data, (2) no/weak implementation of FCTC Article 5.3, (3) industry ties with media professionals and (4) advocates’ limited capacity. To address these challenges, participants suggested initiatives, including access to country-specific data, building advocates’ skills in compiling and using such data in research and monitoring, and in coalition development; others aiming at training journalists to question and investigate TII; and finally, diverse interventions intended to advance a whole-of-government approach to tobacco control. Structural changes to tobacco control funding and coordination were suggested to facilitate the proposed measures.ConclusionThis research highlights that following years of investment in tobacco control in LMICs, there is growing confidence in addressing TII. We identify straightforward initiatives that could strengthen such efforts. This research also underscores that more structural changes to enhance tobacco control capacity building should be considered.

scholarly journals Defending Comprehensive Tobacco Control Policy Implementation in Nepal From Tobacco Industry Interference (2011–2018)

2020 ◽  
Vol 22 (12) ◽  
pp. 2203-2212 ◽  
Author(s):  
Dharma N Bhatta ◽  
Eric Crosbie ◽  
Stella A Bialous ◽  
Stanton Glantz
Keyword(s):  
Tobacco Control ◽  
Tobacco Industry ◽  
Public Awareness ◽  
Control Policy ◽  
Control Law ◽  
Middle Income ◽  
Middle Income Countries ◽  
Awareness Campaigns ◽  
The Law ◽  
Low And Middle Income

Abstract Introduction Nepal passed a comprehensive tobacco control law in 2011. Tobacco control advocates successfully countered tobacco industry (TI) interference to force implementation of law. Aims and Methods Policy documents, news stories, and key informant interviews were triangulated and interpreted using the Policy Dystopia Model (PDM). Results The TI tried to block and weaken the law after Parliament passed it. Tobacco control advocates used litigation to force implementation of the law while the TI used litigation in an effort to block implementation. The TI argued that tobacco was socially and economically important, and used front groups to weaken the law. Tobacco control advocates mobilized the media, launched public awareness campaigns, educated the legislature, utilized lawsuits, and monitored TI activities to successfully counter TI opposition. Conclusions Both tobacco control advocates and the industry used the discursive and instrumental strategies described in the PDM. The model was helpful for understanding TI activities in Nepal and could be applied to other low- and middle-income countries. Civil society, with the help of international health groups, should continue to track TI interference and learn the lessons from other countries to proactively to counter it. Implications The PDM provides an effective framework to understand battles over implementation of a strong tobacco control law in Nepal, a low- and middle-income country. The TI applied discursive and instrumental strategies in Nepal in its efforts to weaken and delay the implementation of the law at every stage of implementation. It is important to continuously monitor TI activities and learn lessons from other countries, as the industry often employ the same strategies globally. Tobacco control advocates utilized domestic litigation, media advocacy, and engaged with legislators, politicians, and other stakeholders to implement a strong tobacco control law. Other low- and middle-income countries can adapt these lessons from Nepal to achieve effective implementation of their laws.

scholarly journals “It is merely a paper tiger.” Battle for increased tobacco advertising regulation in Indonesia: content analysis of news articles

BMJ Open ◽  
2017 ◽  
Vol 7 (9) ◽  
pp. e016975 ◽  
Author(s):  
Putu Ayu Swandewi Astuti ◽  
Becky Freeman
Keyword(s):  
Content Analysis ◽  
Tobacco Control ◽  
News Media ◽  
Tobacco Industry ◽  
Control Policy ◽  
Kappa Statistic ◽  
Policy Instrument ◽  
News Article ◽  
Tobacco Advertising ◽  
Adoption And Implementation

ObjectiveAt the end of 2012, the Indonesian government enacted tobacco control regulation (PP 109/2012) that included stricter tobacco advertising, promotion and sponsorship (TAPS) controls. The PP did not ban all forms of TAPS and generated a great deal of media interest from both supporters and detractors. This study aims to analyse stakeholder arguments regarding the adoption and implementation of the regulation as presented through news media converge.DesignContent analysis of 213 news articles reporting on TAPS and the PP that were available from the Factiva database and the Google News search engine.SettingIndonesia, 24 December 2012–29 February 2016.MethodsArguments presented in the news article about the adoption and implementation of the PP were coded into 10 supportive and 9 opposed categories. The news actors presenting the arguments were also recorded. Kappa statistic were calculated for intercoder reliability.ResultsOf the 213 relevant news articles, 202 included stakeholder arguments, with a total of 436 arguments coded across the articles. More than two-thirds, 69% (301) of arguments were in support of the regulation, and of those, 32.6% (98) agreed that the implementation should be enhanced. Of 135 opposed arguments, the three most common were the potential decrease in government revenue at 26.7% (36), disadvantage to the tobacco industry at 18.5% (25) and concern for tobacco farmers and workers welfare at 11.1% (15). The majority of the in support arguments were made by national government, tobacco control advocates and journalists, while the tobacco industry made most opposing arguments.ConclusionsAnalysing the arguments and news actors provides a mapping of support and opposition to an essential tobacco control policy instrument. Advocates, especially in a fragmented and expansive geographic area like Indonesia, can use these findings to enhance local tobacco control efforts.

scholarly journals Strategies and barriers to achieving the goal of Finland’s tobacco endgame

2019 ◽  
pp. tobaccocontrol-2018-054779 ◽  
Author(s):  
David S Timberlake ◽  
Ulla Laitinen ◽  
Jaana M Kinnunen ◽  
Arja H Rimpela
Keyword(s):  
Tobacco Control ◽  
Structural Changes ◽  
Structured Interviews ◽  
Institutional Practices ◽  
Or Practice ◽  
Control Community ◽  
Legal Constraints ◽  
Future Policy ◽  
Study Participants ◽  
Tobacco Endgame

ObjectivesFinland boldly legislated the end of tobacco use in its 2010 Tobacco Act, and subsequently expanded the goal in 2016 to eradicate other nicotine-containing products. This study explored stakeholders’ perceptions about the strengths, barriers, solutions and rationale for Finland’s comprehensive but conventional strategy to achieve its nicotine-free goal.DesignStudy participants were selected based on expertise in policy or practice of tobacco control (n=32). Semi-structured interviews, conducted in 2017 and 2018, covered topics ranging from consensus among stakeholders to Finland’s ranking on the 2016 Tobacco Control Scale. The framework method was chosen for analysing interview transcripts.ResultsA perceived strength of Tobacco-Free Finland 2030 was the consensus and cooperation among members of the tobacco control community. The objective of becoming a nicotine- versus smoke-free society had almost unanimous support, challenged by a small minority who argued for greater discussion of harm reduction approaches. The need for maintaining legitimacy and historical successes in tobacco control were reasons for using a conventional strategy. Barriers to achieving the endgame goal included insufficient funding and over-reliance on non-governmental organisations, political/legal constraints, impact of institutional practices on tobacco disparities, ambivalence about the role of mass media and lack of prioritising smoking cessation.ConclusionsStakeholders’ broad confidence in reaching the goal of Finland’s tobacco endgame suggests that future policy initiatives will reflect the current, conventional strategy. If the Finnish government chooses to continue this approach, then it should designate separate funds for Tobacco-Free Finland 2030 and implement structural changes that will facilitate tobacco control initiatives.

scholarly journals Exceeding WHO Framework Convention on Tobacco Control (FCTC) Obligations: Nepal Overcoming Tobacco Industry Interference to Enact a Comprehensive Tobacco Control Policy

2019 ◽  
Vol 22 (12) ◽  
pp. 2213-2223 ◽  
Author(s):  
Dharma N Bhatta ◽  
Stella Bialous ◽  
Eric Crosbie ◽  
Stanton Glantz
Keyword(s):  
Tobacco Control ◽  
Financial Support ◽  
Tobacco Industry ◽  
International Health ◽  
Control Policy ◽  
Economic Importance ◽  
Political Transition ◽  
Tobacco Control Policy ◽  
Control Law ◽  
International Agencies

Abstract Background The tobacco industry works to block, delay, and weaken national tobacco control legislation to implement the WHO Framework Convention on Tobacco Control (FCTC). This article reviews how Nepal overcame industry opposition and to a comprehensive tobacco control law implementing the FCTC. Methods We triangulated newspaper articles and policy documents with key informant interviews. Results With the support of international health groups, local tobacco control advocates worked with policymakers in Nepal to pass a comprehensive tobacco control law that exceeded FCTC obligations. The tobacco industry exploited a time of political transition to block consideration by Parliament, arranged and sponsored foreign tours for legislators, made death threats to tobacco control advocates and their families, and argued for the economic importance of tobacco farms. Despite strong interference from Health, and Law and Justice ministers, a 2009 Supreme Court ruling helped tobacco control advocates secure a comprehensive tobacco control law in 2011 that included rotating pictorial health warning labels covering 75% of both sides of cigarette packages, 100% smoke free public places and workplaces, private homes and vehicles, and a tobacco advertising, promotion, and sponsorship ban. Conclusions Advocates in developing countries should utilize Nepal's experience to reject tobacco industry offers of compromise and continue educating politicians and legislators to generate political support to pass a comprehensive tobacco control law. Technical and financial support from international agencies, and effective collaboration and coordination of civil societies, and utilization of domestic litigation are helpful in LMICs where governance is weak (the abstract in Nepali is available as a Supplementary Material). Implications The tobacco industry exploited a time of political transition in Nepal in its effort to block comprehensive tobacco control policy in Parliament by sponsoring foreign tours of legislatures, making death threats to tobacco control advocates and their families, and arguing for the economic importance of tobacco farms. Tobacco control advocates used litigation to raise awareness and educate legislators and promote strong legislation with the involvement of international health groups. Technical and financial support from international agencies, and effective collaboration and coordination of civil societies, and utilization of domestic litigation are helpful in LMICs where governance is weak.

scholarly journals Developing more detailed taxonomies of tobacco industry political activity in low-income and middle-income countries: qualitative evidence from eight countries

2021 ◽  
Vol 6 (3) ◽  
pp. e004096
Author(s):  
Britta Katharina Matthes ◽  
Kathrin Lauber ◽  
Mateusz Zatoński ◽  
Lindsay Robertson ◽  
Anna B Gilmore
Keyword(s):  
Tobacco Control ◽  
Low Income ◽  
Tobacco Industry ◽  
Political Activity ◽  
Control Policies ◽  
Middle Income ◽  
Political Activities ◽  
Middle Income Countries ◽  
Tobacco Control Policies ◽  
Starting Point

IntroductionHistorical evidence, predominantly from high-income countries (HICs), shows that the tobacco industry uses a recurring set of arguments and techniques when opposing tobacco control policies. This data formed the basis of a model of tobacco industry political activity known as the policy dystopia model (PDM). The PDM has been widely used in tobacco control research and advocacy and has subsequently been shown relevant to other unhealthy commodities industries in both HICs and low-income and middle-income countries (LMICs). Before it can be validated as a generic tool for researching corporate influence on policy, one needs to determine whether the PDM successfully captures contemporary corporate political activities in LMICs.MethodWe conducted semistructured interviews with 22 LMIC-based advocates and used the transcripts as the primary data source. The discursive and instrumental taxonomies constituting the PDM served as the starting point for the coding framework. Using thematic analysis, we combined deductive and inductive coding to ensure we captured all strategies from the PDM and the interviews.ResultsThis study found that the tobacco industry uses a set of discursive and instrumental strategies that is largely consistent across LMICs and with the PDM. We identified several minor contextual nuances absent from the PDM. Some of these nuances were characteristic to individual countries, while others to LMICs more broadly. They included the argument that tobacco control policies unfairly punish reputable tobacco industry actors, and an emphasis on instrumental strategies centred around maintaining a good image, rather than rehabilitating a tarnished image as emphasised in the PDM.ConclusionsAllowing for the nuances identified in this study, the PDM has been found to be fit for purpose. The revised model should now be tested through in-depth LMIC case studies and could be used to facilitate comparative studies of unhealthy commodity industries’ political activities.

scholarly journals Using market data to understand corporate behaviour

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
R Hiscock
Keyword(s):  
Tobacco Control ◽  
Tobacco Industry ◽  
National Level ◽  
Control Policy ◽  
Tobacco Product ◽  
Tobacco Control Policy ◽  
Market Data ◽  
Tobacco Taxes ◽  
Level Statistics ◽  
Product Sales

Abstract Background Tobacco companies sell tobacco in order to invest in the business and make profits for shareholders. One element in creating profitability is via data driven marketing. Such data are also useful for public health because an understanding of pricing and sales patterns can help with the development of effective tobacco control methods by understanding how the tobacco industry is making profits. Methods Study 1) Public and commercial databases which provide free or paywalled access to market data were identified. Internet searches were conducted to understand more about their ownership, mission of the owners, funding and accessibility Study 2) University of Bath studies using such datasets to understand the tobacco industry were reviewed to synergise the ways in which corporate behaviour has undermined tobacco control policy. Results The United Nations provides freely accessible national level statistics on imports and exports of raw tobacco and manufactured tobacco products. Limited survey data may be available on the last product smoked. Proprietary databases are expensive, may have usage restrictions and links to the tobacco industry but can provide a detailed picture of tobacco product sales and prices. Research on such databases has illustrated how the tobacco industry kept cheap tobacco available despite tobacco taxes, used tax rises to increase their own revenue and used a standardised packaging sell through period to keep branded packs on the market for longer. Conclusions Governments should require the tobacco industry to provide market data in an easily publishable form Key messages The most detailed data on the tobacco market is proprietary. Proprietary databases are expensive, may have usage restrictions and links to the tobacco industry. Understanding of pricing and sales patterns can help with evaluating the effectiveness of tobacco control policy.

Successful countering of tobacco industry efforts to overturn Thailand's ENDS ban

2020 ◽  
pp. tobaccocontrol-2020-056058
Author(s):  
Roengrudee Patanavanich ◽  
Stanton Glantz
Keyword(s):  
Public Relations ◽  
Harm Reduction ◽  
Tobacco Control ◽  
Tobacco Industry ◽  
Shared Vision ◽  
Tobacco Products ◽  
Middle Income ◽  
Philip Morris ◽  
Social Media Platforms ◽  
The Government

BackgroundAfter Thailand enacted laws to ban the import and sale of all types of electronic nicotine delivery systems (ENDS, including e-cigarettes and heated tobacco products (HTPs)) in 2015, pro-ENDS advocacy groups pressured the government to lift the ban, particularly after Philip Morris International (PMI) started promoting its HTP IQOS in 2017.MethodsWe reviewed information related to ENDS in Thailand between 2014 and 2019 from Thai newspaper articles, meeting minutes and letters submitted to government agencies, websites and social media platforms of pro-ENDS networks and Thai tobacco control organisations.ResultsThe tobacco industry and the pro-ENDS groups used five tactics to try to reverse the Thai ban on ENDS: creating front groups, lobbying decision-makers, running public relations campaigns, seeking to discredit tobacco control advocates and funding pro-tobacco harm reduction research. ENDS Cigarette Smoking Thailand (ECST), a pro-ENDS group in Thailand, worked in parallel with Philip Morris Thailand Limited (PMTL) to oppose the ban. The group connected with international coalitions that promote harm reduction through the PMI-funded Foundation for a Smoke-Free World.ConclusionAlthough ECST and PMTL continuously worked to revoke the ban since 2017, the government still kept ENDS illegal as of October 2020. This decision resulted from the strong commitment and collaboration among Thai tobacco control organisations and their shared vision to protect the public’s health from harmful tobacco products. The linkages between the pro-ENDS movement in Thailand and the tobacco companies could inform health advocates and policy-makers in other low and middle income countries facing pressure to market ENDS.

The Politics of Global Tobacco Control

2019 ◽  
pp. 659-683
Author(s):  
Kelley Lee
Keyword(s):  
Public Health ◽  
Tobacco Control ◽  
Tobacco Industry ◽  
Control Policy ◽  
World Health ◽  
Health Issue ◽  
Public Health Issue ◽  
Illicit Trade ◽  
Health Organization ◽  
Transnational Tobacco Companies

This chapter examines the politics that has shifted tobacco control policy over the past three decades, from a long-neglected public health issue to a flagship global health issue supported by collective action by state and non-state actors. These efforts were spurred by the expansion of leading transnational tobacco companies (TTCs) into emerging markets, beginning in the 1960s, amid growing regulation and declining sales in traditional markets. By the 1990s tobacco use was steadily rising in the wake of the global expansion of the tobacco industry. The negotiation of the World Health Organization Framework Convention on Tobacco Control (FCTC) became the focus of intense political contestation between a powerful industry seeking to protect its commercial interests and an alarmed public health community. Since adoption of the FCTC in 2004, this political battle has shifted to its effective implementation in signatory states. This has included the eventual negotiation of the FCTC Protocol to Eliminate the Illicit Trade in Tobacco Products and continued efforts by the tobacco industry to sustain sales through a variety of political strategies.

scholarly journals Tobacco control in Nepal during a time of government turmoil (1960–2006)

2019 ◽  
pp. tobaccocontrol-2019-055066 ◽  
Author(s):  
Dharma Bhatta ◽  
Eric Crosbie ◽  
Stella Bialous ◽  
Stanton Glantz
Keyword(s):  
Tobacco Control ◽  
Low Income ◽  
Tobacco Industry ◽  
Supreme Court Decision ◽  
Tobacco Company ◽  
Executive Orders ◽  
Middle Income ◽  
Tobacco Tax ◽  
The Government ◽  
Transnational Tobacco Companies

BackgroundNepal was a monarchy, then a dictatorship, then a democracy. This paper reviews how tobacco control progressed in Nepal in the context of these changes in government from 1950 through 2006.MethodsWe triangulated tobacco industry documents, newspaper articles and key informant interviews.ResultsUntil 1983, the tobacco industry was mostly state owned. Transnational tobacco companies entered the Nepalese market through ventures with Surya Tobacco Company Private Limited (with Imperial Tobacco Company and British American Tobacco) in 1983 and Seti Cigarette Factory Limited (with Philip Morris International [PMI]) in 1985. Seminars and conferences on tobacco, celebrations of World No Tobacco Day (WNTD) and efforts by WHO helped promote tobacco control in Nepal beginning in the 1970s. Tobacco advocates in Nepal pushed the government to issue executive orders banning smoking in public places in 1992 and tobacco advertising in electronic media in 1998, and to introduce a tobacco health tax in 1993. The tobacco industry lobbied against these measures and succeeded in keeping the tobacco tax low by challenging it in court. Tobacco advocates sued the government in 2003 and 2005, resulting in a June 2006 Supreme Court decision upholding the smoking and advertising bans and requiring the government to enact a comprehensive tobacco control law.ConclusionsPolitical instability, conflict, weak governance and the dictatorship significantly affect tobacco control activities in low-income and middle-income countries. Nepal shows that tobacco control advocates can take advantage of global events, such as WNTD, and use domestic litigation to maintain support from civil societies and to advocate for stronger tobacco control policies.

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