The World Health Organization (WHO) Framework Convention for Tobacco Control (FCTC) is one of the most widely accepted treaties in the United Nations system. It represents an attempt by governments to address the global tobacco epidemic. It contains a ‘comprehensive’ set of measures to reduce the demand for, and supply of, tobacco products worldwide. In most countries, it has prompted an increase in the number and depth of policy instruments. It primarily sets the agenda for change rather than providing the means to ensure the domestic implementation of policy. Implementation has been uneven; it is more evident in ‘developed’ than ‘developing’ countries. We identify the policy processes that would have to change to ensure more successful global implementation.
The number of policies adopted across the globe has increased markedly since the negotiation of the FCTC. However, the implementation of policy has been uneven. The developed-developing country distinction provides an important way to describe this outcome, since most progress has been made in developed countries. However, it does not explain the uneven implementation of the FCTC; ‘development’ is not the causal factor. We synthesise the public policy literature to identify the key causal factors . We identify the most relevant characteristics of the policy processes within ‘leading’ countries with the most comprehensive tobacco control: their department of health has taken the policy lead (replacing trade and treasury departments); tobacco is ‘framed’ as a pressing public health problem (not an economic good); public health groups are more consulted (often at the expense of tobacco companies); socioeconomic conditions (including the value of tobacco taxation, and public attitudes to tobacco control) are conducive to policy change; and, the scientific evidence on the harmful effects of smoking and secondhand smoking are ‘set in stone’ within governments. These factors tend to be absent in the countries with limited controls. We argue that, in the absence of these wider changes in their policy environments, the countries most reliant on the FCTC are currently the least able to implement it.
The long version of the paper is here: Cairney Mamudu 2013 Implementing the FCTC_ Insights From Public Policy
- After the War on Tobacco, Is a War on Alcohol Next?* (paulcairney.wordpress.com)