Policy makers' perspectives on tobacco control advocates' roles in regulation development

BackgroundThe Healthy China 2030 strategy sets ambitious targets for China’s policy-makers, including a decrease in the smoking rate from 27.7% in 2015 to 20% by 2030. China has made progress on tobacco control in recent years, but many key measures remain underused. This study explores the potential for full implementation of these measures to achieve the targeted reduction in smoking by 2030.MethodsFirst, a ‘business as usual’ scenario for China’s cigarette market was developed based only on underlying economic parameters. Second, non-price tobacco control measures were then added assuming they are fully implemented by 2030. Third, excise per pack was raised to a level that would increase the real price of cigarettes by 50% in 2030.FindingsUnder the business as usual scenario, the rate of smoking falls to around 26.6% in 2030. When non-price measures are included, the rate of smoking falls to 22.0% (20.9%~23.1%). Thus, non-price measures alone are unlikely to achieve the Healthy China target. Under the third scenario, excise per pack was roughly doubled in 2030 in order to increase real cigarette prices by 50%. The rate of smoking then falls to 19.7% (18.2%~21.3%), reflecting 78 million (59~97 million) fewer smokers compared with 2016. In addition, real excise revenue from cigarettes increases by 21% (−3%~47%) compared with 2016.ConclusionSignificantly higher tobacco taxes will be needed to achieve Healthy China 2030 target for reduced smoking even after the implementation of other tobacco control measures.

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Addressing Tobacco Use in Homeless Populations

Health Promotion Practice ◽

10.1177/1524839911414412 ◽

2011 ◽

Vol 12 (6_suppl_2) ◽

pp. 144S-151S ◽

Cited By ~ 17

Author(s):

Janet Porter ◽

Lisa Houston ◽

Robert H. Anderson ◽

Kristi Maryman

Keyword(s):

Tobacco Control ◽

Tobacco Use ◽

Service Providers ◽

Homeless Persons ◽

Washington Dc ◽

Policy Makers ◽

Panel Model ◽

Control And Prevention ◽

National Networks ◽

Smoking And Health

A diverse group of panelists met for one day on October 21, 2009, in Washington, DC, for the purpose of addressing the high tobacco use prevalence rates in homeless populations; identifying appropriate policy, cessation practices and models for implementation in this population; and providing targeted recommendations for researchers, homeless service providers, tobacco control advocates, and policy makers. The panel was convened by Break Free Alliance, one of six national networks funded by the Centers for Disease Control and Prevention, Office on Smoking and Health. The panelists worked through a process of problem identification, generation of responses, analysis and prioritization, development of recommendations, and arrival of final decisions reached by consensus. The resulting recommendations for addressing tobacco use in homeless populations focused on tobacco non-use policy implementation, cessation programming, and expansion of partnerships and collaborations between tobacco control advocates and social service providers. The panel also identified unanswered research questions that can serve to develop a framework for future initiatives to reduce tobacco use among homeless persons. The expert panel model serves as one approach for engaging nontraditional partners and building consensus among leaders from a variety of sectors to address tobacco use in special populations.

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Health Impact of and Policy Regulations on Electronic Cigarettes

Acta Medica Philippina ◽

10.47895/amp.v52i5.307 ◽

2019 ◽

Vol 52 (5) ◽

Author(s):

Hilton Y. Lam ◽

Carlo Irwin A. Panelo ◽

Ofelia P. Saniel ◽

Carmelita C. Canila ◽

Jonathan P. Guevarra ◽

...

Keyword(s):

Tobacco Control ◽

Delivery System ◽

The Philippines ◽

Policy Position ◽

Policy Statement ◽

Evidence Based ◽

Policy Makers ◽

Safety And Efficacy ◽

Nicotine Delivery ◽

New Findings

Background. New findings on the detrimental health effects of electronic nicotine delivery system (ENDS)/ electronic non-nicotine delivery system (ENNDS) confounds the “harm reduction” perspective of using it as an alternative to conventional cigarettes. In the Philippines, the pressing debate on its safety and efficacy had initiated actions from policy makers on legislative issues such as draft DOH Administrative Order, House Bill 4325 and House Bill 532. Objective. The study aimed to craft an evidence-based policy position on the regulation of ENDS/ENNDS. Method. Review of literature was conducted, and the proposed scope and measures on electronic cigarette regulation were compared with WHO Framework Convention on Tobacco Control (WHO-FCTC) and existing policies of US FDA regulations on ENDS. Further, UP Manila convened experts of various related fields for evidence-based review and discussion of policy issues to arrive at a consensus policy statement and recommendations. Results. Findings showed that ENDS/ENNDS still need further research to have conclusive results on long term safety and efficacy as smoking cessation methods. Conclusion. Regulations for tobacco control should be clear and supported with strict guidelines in manufacturing, distribution, advertisement, selling, and usage restrictions in public. With the current review, it is recommended that ENDS/ENNDS regulation be under the mandate of the FDA in alignment to WHO-FCTC and to engage different stakeholders from policy makers, implementers, and other involved organizations.

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Two heads are better than one: Australian tobacco control experts’ and mental health change champions’ consensus on addressing the problem of high smoking rates among people with mental illness

Australian Health Review ◽

10.1071/ah15028 ◽

2016 ◽

Vol 40 (2) ◽

pp. 155 ◽

Cited By ~ 2

Author(s):

Della Rowley ◽

Sharon Lawn ◽

John Coveney

Keyword(s):

Public Health ◽

Mental Health ◽

Mental Illness ◽

Tobacco Control ◽

Health Sector ◽

Success Rates ◽

Smoking Reduction ◽

Policy Makers ◽

Government Services ◽

People With Mental Illness

Objective The aims of the present study were to explore the beliefs of Australian experts in tobacco control and change champions working in mental health and tobacco cessation, and to identify measures for addressing the problem of high smoking rates for people with mental illness. Methods Qualitative interviews were undertaken to explore participants’ views, and the Delphi technique was used to achieve consensus on ways in which the problem would be best addressed. Results This consensus centred on the need for leadership within the mental health system. The problem was reconceptualised from being solely the responsibility of the mental health sector into an issue that requires the combined resources of a partnership and shared leadership between government and non-government services, public health leaders, policy makers and people with mental illness and their families. Conclusions Collaboration would raise the priority of the issue, reduce the debilitating effect of stigma and discrimination within the mental health sector and would place smoking reduction firmly on the political and public agenda. A recovery-orientated focus would increase the skill base and be inclusive of workers, families and carers of people with mental illness who face smoking issues on a daily basis. Reconceptualising this as an issue that would benefit from cooperation and partnerships would disrupt the notion that the problem is solely the responsibility of the mental health sector. What is known about the topic? Rates of smoking have remained high for people with mental illness despite population-wide public health strategies successfully reducing smoking rates in the general population. For people with mental illness, the benefits of quitting smoking for both their mental and physical health are overshadowed by concerns about the complexity of their needs. There is a lack of knowledge about how smoking cessation support can be improved to increase success rates in smokers with mental illness. What does this paper add? The present study is the first to bring a cross-sector lens of public health and mental health ‘experts’ together to discuss the reasons for the high rates of smoking among people with mental illness and to obtain their shared agreement on solutions. This Australian-specific study analyses participants’ responses to the problem representation and reveals what the issue is considered to be, where action should occur and how the problem should be resolved. What are the implications for practitioners? For the Australian context, there is a need for leadership and a consistent smoke-free message about the benefits of not smoking. Staff working in mental health require training in providing brief interventions, motivational interviewing and pharmacological support. Joining together as a partnership of government and non-government services, including public health leaders and policy makers, and involving people with mental illness and their families, would benefit all concerned.

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Implementation research for taking tobacco control policies to scale in India: a realist evaluation study protocol

BMJ Open ◽

10.1136/bmjopen-2021-050859 ◽

2021 ◽

Vol 11 (5) ◽

pp. e050859

Author(s):

Pragati Bhaskar Hebbar ◽

Vivek Dsouza ◽

Upendra Bhojani ◽

Onno CP van Schayck ◽

Giridhara R Babu ◽

...

Keyword(s):

Tobacco Control ◽

Low Income ◽

Implementation Process ◽

Control Program ◽

Evaluation Study ◽

Realist Evaluation ◽

Indian States ◽

Control Policies ◽

Policy Makers ◽

Tobacco Control Policies

IntroductionThere are ongoing policies and programs to reduce tobacco use and minimise the associated health burden in India. However, there are several challenges in practice leading to different outcomes across Indian states. Inadequate understanding of how national tobacco control policies achieve their results under varied circumstances obstruct the implementation and scaling up of effective strategies. This study is a realist evaluation using largely qualitative methods to understand the implementation process of India’s tobacco control policies. It will do so by evaluating India’s Cigarettes and Other Tobacco Products Act (COTPA) and the National Tobacco Control Program (NTCP). The study aims to examine how, why, for whom and under which circumstances COTPA and NTCP are implemented in India.Methods and analysisA realist synthesis on implementation of tobacco control policies in low-income and middle-income countries is conducted. This is followed by qualitative data collection and analysis in three Indian states selected based on data from two rounds of the Global Adult Tobacco Survey. The study comprises of three steps (1): development of initial programme theories, (2) testing and refinement of initial programme theories and (3) testing and validation of refined programme theories. We will interview policy-makers, programme managers and implementers to identify facilitators and barriers of implementation. The purpose is to identify context-specific evidence-based strategies to gain insights into the implementation process of COTPA and NTCP. Further we aim to contribute to tobacco control research by establishing communities of practice to engage with cross-cutting issues.Ethics and disseminationThe Institutional Ethics Committee, at the Institute of Public Health (Bengaluru), has approved the protocol. Written informed consent forms will be obtained from all the participants. Dissemination has been planned for researchers, policy-makers and implementers as well as the public through peer-reviewed publications, conference presentation, webinars and social media updates.PROSPERO registration numberCRD42020191541.

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Exploration of Policy Makers’ Views on the Implementation of the Framework Convention on Tobacco Control in the Gambia: A Qualitative Study

Nicotine & Tobacco Research ◽

10.1093/ntr/ntz003 ◽

2019 ◽

Vol 21 (12) ◽

pp. 1652-1659 ◽

Cited By ~ 1

Author(s):

Isatou K Jallow ◽

John Britton ◽

Tessa Langley

Keyword(s):

Qualitative Study ◽

Tobacco Control ◽

Public Awareness ◽

Policy Formulation ◽

The Gambia ◽

World Health ◽

African Countries ◽

Control Policies ◽

Policy Makers ◽

Tobacco Control Policies

Abstract Background The World Health Organization’s Framework Convention on Tobacco Control (FCTC) is the first international health treaty and has now been ratified by 181 countries. However, there are concerns that in many countries, particularly in sub-Saharan African countries, FCTC legislations and implementation are weak. In this study, we report a qualitative study undertaken to assess policy makers’ awareness of the FCTC and national tobacco control policies, and assessed the achievements and challenges to the implementation of the FCTC in the Gambia. Methods The study involved semi-structured one-to-one interviews with 28 members of the National Tobacco Control Committee in the Gambia, which is responsible for formulating tobacco control policies and making recommendations for tobacco control. We used the Framework method and NVivo11 software for data analysis. Results Our findings demonstrate that the Gambia has made modest progress in tobacco control before and since ratification of the FCTC, particularly in the areas of policy formulation, bans on tobacco advertising and promotion, smoke-free laws, and tobacco taxation. Although several pieces of tobacco control legislation exist, enforcement and implementation remain a major challenge. We found that policy makers’ awareness of polices covered in the FCTC was limited. Conclusion Our findings highlight several challenges to the FCTC implementation and the need to step up efforts that will help to accomplish the obligations of the FCTC. To achieve the obligations of the FCTC, the Gambia should develop specific public awareness interventions, establish cessation services, mobilize adequate resources for tobacco control and strengthen tobacco surveillance and research.

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The Transformation of UK Tobacco Control

Great Policy Successes ◽

10.1093/oso/9780198843719.003.0005 ◽

2019 ◽

pp. 84-103

Author(s):

Paul Cairney

Keyword(s):

Public Health ◽

Tobacco Control ◽

Policy Change ◽

Behavioural Change ◽

Policy Instrument ◽

Smoking Ban ◽

Policy Environment ◽

Policy Makers ◽

The Uk ◽

Evidence Based Model

The UK has one of the most comprehensive set of tobacco controls in the world. For public health advocates, its experience is an ‘evidence-based’ model for tobacco control across the globe, and for alcohol and obesity policies in the UK. In Scotland, policy-makers often described the ‘smoking ban’ as legislation so innovative that it helped justify devolution. These broad and specific experiences allow us to identify and explain different types of success. The UK’s success relates to smoking ‘denormalization’ and reduction, and the explanation comes partly from the ways in which policy-makers framed tobacco as a public health epidemic and produced a policy environment conducive to policy change. The ‘smoking ban’ success relates to the implementation and behavioural change that is lacking in most other countries. The explanation comes from the ‘window of opportunity’ for specific policy change, and the design of the policy instrument backed by the prioritization of its delivery by key public bodies. The overall lesson, particularly for advocates of evidence-informed policymaking, is that evidence only ‘wins the day’ when it helps reframe debate, produce a conducive policy environment, and actors exploit ‘windows of opportunity’ for specific reforms. In most countries, this did not happen.

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Informing policy makers on the efficiency of population level tobacco control interventions in Asia: A systematic review of model-based economic evaluations

Journal of Global Health ◽

10.7189/jogh.10.020437 ◽

2020 ◽

Vol 10 (2) ◽

Author(s):

Ariuntuya Tuvdendorj ◽

Yihui Du ◽

Grigory Sidorenkov ◽

Erik Buskens ◽

Geertruida H de Bock ◽

...

Keyword(s):

Systematic Review ◽

Tobacco Control ◽

Population Level ◽

Economic Evaluations ◽

Policy Makers ◽

Model Based

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Biosecurity: tools, behaviours and concepts

Emerging Topics in Life Sciences ◽

10.1042/etls20200343 ◽

2020 ◽

Vol 4 (5) ◽

pp. 449-452

Author(s):

Alan MacLeod ◽

Nicola Spence

Keyword(s):

Plant Protection ◽

Human Life ◽

Animal Health ◽

Early Warning Systems ◽

Policy Makers ◽

Recent Developments ◽

Surveillance Programs ◽

Harmful Organisms ◽

The One ◽

Biosecurity Practices

COVID 19 has raised the profile of biosecurity. However, biosecurity is not only about protecting human life. This issue brings together mini-reviews examining recent developments and thinking around some of the tools, behaviours and concepts around biosecurity. They illustrate the multi-disciplinary nature of the subject, demonstrating the interface between research and policy. Biosecurity practices aim to prevent the spread of harmful organisms; recognising that 2020 is the International Year of Plant Health, several focus on plant biosecurity although invasive species and animal health concerns are also captured. The reviews show progress in developing early warning systems and that plant protection organisations are increasingly using tools that compare multiple pest threats to prioritise responses. The bespoke modelling of threats can inform risk management responses and synergies between meteorology and biosecurity provide opportunities for increased collaboration. There is scope to develop more generic models, increasing their accessibility to policy makers. Recent research can improve pest surveillance programs accounting for real-world constraints. Social science examining individual farmer behaviours has informed biosecurity policy; taking a broader socio-cultural approach to better understand farming networks has the potential to change behaviours in a new way. When encouraging public recreationists to adopt positive biosecurity behaviours communications must align with their values. Bringing together the human, animal, plant and environmental health sectors to address biosecurity risks in a common and systematic manner within the One Biosecurity concept can be achieved through multi-disciplinary working involving the life, physical and social sciences with the support of legislative bodies and the public.

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Suicide on the Indian Subcontinent

Crisis ◽

10.1027//0227-5910.23.3.104 ◽

2002 ◽

Vol 23 (3) ◽

pp. 104-107 ◽

Cited By ~ 36

Author(s):

Murad M. Khan

Keyword(s):

Sri Lanka ◽

Mental Health Professionals ◽

Indian Subcontinent ◽

Interpersonal Relationship ◽

Public Health Problem ◽

Elderly Subjects ◽

Important Public Health Problem ◽

Policy Makers ◽

Formidable Challenge ◽

Causative Factors

Summary: The Indian subcontinent comprises eight countries (India, Pakistan, Bangladesh, Nepal, Sri Lanka, Afghanistan, Bhutan, and the Maldives) and a collective population of more than 1.3 billion people. 10% of the world's suicides (more than 100,000 people) take place in just three of these countries, viz. India, Sri Lanka, and Pakistan. There is very little information on suicides from the other four countries. Some differences from suicides in Western countries include the high use of organophosphate insecticides, larger numbers of married women, fewer elderly subjects, and interpersonal relationship problems and life events as important causative factors. There is need for more and better information regarding suicide in the countries of the Indian subcontinent. In particular, studies must address culture-specific risk factors associated with suicide in these countries. The prevention of this important public health problem in an area of the world with myriad socio-economic problems, meager resources, and stigmatization of mental illness poses a formidable challenge to mental health professionals, policy makers, and governments of these countries.

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