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Tobacco Control: Challenges, Policies and Interventions

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601).

Deadline for manuscript submissions: closed (28 February 2024) | Viewed by 17694

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Dr. Catherine O. Egbe

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Guest Editor

Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, Tygerberg 7505, South Africa
Interests: tobacco control policy; aetiology and epidemiology of tobacco use; tobacco use cessation; tobacco industry documents research and monitoring

Special Issue Information

Dear Colleagues,

Tobacco use is the leading preventable cause of death and disease globally. Following the exponential increase in tobacco-related diseases in many parts of the world, notably cancers and cardiovascular diseases, the World Health Organization Framework Convention on Tobacco Control (FCTC) was negotiated among member countries of the United Nations under the auspices of the WHO (the first of its kind). The WHO FCTC is an international treaty that emphasizes the importance of instituting evidence-based strategies to reduce the supply and demand of tobacco products. The FCTC also provides a framework of tobacco control measures to guide parties to the treaty at national, regional, and international levels. Since 2005 when the FCTC came into force, there has been some recorded progress in reducing the burden of tobacco use globally. However, there have also been some challenges both at national and international levels. With the emergence of novel tobacco and nicotine products in recent years and the ever-manipulative tactics of the tobacco and related industry players, these challenges have become more threatening toward the achievements made over the years in tobacco control. Additionally, the emergence of new products that fall outside definitions of traditional tobacco products poses a risk to the effective implementation of tobacco control policies in many countries, with laws needing to be revised or changed in order to bring all tobacco and nicotine products within national tobacco control legislative frameworks while aggressive marketing of these products is carried out unabated. This Special Issue focuses on exploring the challenges, policies, and interventions the global community, regions and countries are facing or putting in place, as the case may be, as measures to control tobacco.

Disclaimer: We will not accept research funded in part or full by any tobacco companies in this Special Issue. For more details, please check: https://www.mdpi.com/1660-4601/15/12/2831/htm.

Dr. Catherine O. Egbe
Guest Editor

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Keywords

tobacco
tobacco control
tobacco control policy
tobacco control legislation
WHO Framework for Tobacco Control (FCTC)
interventions to reduce tobacco use
challenges of tobacco control
barriers to the implementation of tobacco control policies
policy interventions in tobacco control
emerging tobacco and nicotine products

Published Papers (5 papers)

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Research

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18 pages, 371 KiB

Open AccessArticle

Adopting a WHO Framework Convention on Tobacco Control-Based Tobacco Control Law in Ethiopia: Sustained Transnational Health Advocacy and Multi-Sectoral Institutionalized Support

by Eric Crosbie, Kyle Edison, Vandyke Maclean, Dereje Moges, Caroline Fuss, Monique E. Muggli, Bintou Camara Bityeki and Ernesto M. Sebrié

Int. J. Environ. Res. Public Health 2024, 21(3), 280; https://doi.org/10.3390/ijerph21030280 - 28 Feb 2024

Viewed by 1282

Abstract

Objective: The objective of this study was to document how Ethiopia adopted a WHO Framework Convention on Tobacco Control (FCTC)-based tobacco control law. Methods: We analyzed publicly available documents, including news media articles, advocacy reports, and government documents. We triangulated these findings by interviewing nine key stakeholders. Data were analyzed to construct a historical and thematic narrative and analyzed through a retrospective policy analysis. Results: Local and international health advocacy efforts helped introduce and support WHO FCTC-based legislation by (1) educating policymakers about the WHO FCTC, (2) providing legal assistance in drafting legislation, (3) generating local data to counter industry claims, and (4) producing media advocacy to expose industry activity. Health advocates worked closely with government officials to create a multi-sectoral tobacco committee to institutionalize efforts and insulate tobacco companies from the policymaking process. Japan Tobacco International bought majority shares of the government-owned tobacco company and attempted to participate in the process, using standard industry tactics to undermine legislative efforts. However, with health advocacy assistance, government officials were able to reject these attempts and adopt a WHO FCTC-based law in 2019 that included 100% smoke-free indoor places, a comprehensive ban on tobacco advertising, and large pictorial health warning labels, among other provisions. Conclusion: Sustained local health advocacy efforts supported by international technical and financial assistance can help establish WHO FCTC-based tobacco control laws. Applying a standardized multi-sectoral approach can establish coordinating mechanisms to further institutionalize the WHO FCTC as a legal tool to build support with other government sectors and insulate the tobacco industry from the policymaking process. Full article

(This article belongs to the Special Issue Tobacco Control: Challenges, Policies and Interventions)

17 pages, 1094 KiB

Open AccessArticle

Tobacco Vendors’ Perceptions and Compliance with Tobacco Control Laws in Nigeria

by Omotayo F. Fagbule, Catherine O. Egbe and Olalekan A. Ayo-Yusuf

Int. J. Environ. Res. Public Health 2023, 20(22), 7054; https://doi.org/10.3390/ijerph20227054 - 12 Nov 2023

Viewed by 6013

Abstract

Tobacco vendors are critical stakeholders in the tobacco supply chain. This study examined their perception, compliance, and potential economic impact of Nigeria’s tobacco control laws related to the retail setting. This was a qualitative study involving in-depth interviews of 24 purposively selected tobacco vendors. The face-to-face interviews were aided by a semi-structured interview guide, audio-recorded, transcribed verbatim, and analyzed using thematic analysis with NVivo version 12. Five themes emerged, encompassing reasons for selling tobacco, awareness, perception, compliance with tobacco sales laws, the potential economic impact of the laws, and law enforcement activities. Vendors commenced tobacco sales due to consumers’ demand, profit motives, and advice from close family relatives. They were unaware and non-compliant with most of the retail-related laws. Most participants had positive perceptions about the ban on sales to and by minors, were indifferent about the ban on Tobacco Advertising Promotion and Sponsorships (TAPS) and product display, and had negative perceptions about the ban on sales of single sticks. Most vendors stated quitting tobacco sales would not have a serious economic impact on their business. In conclusion, the vendors demonstrated limited awareness and non-compliance with various retail-oriented tobacco control laws in Nigeria. Addressing these gaps requires targeted educational campaigns and effective law enforcement strategies to enhance vendors’ compliance. Full article

(This article belongs to the Special Issue Tobacco Control: Challenges, Policies and Interventions)

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9 pages, 600 KiB

Open AccessArticle

Preemption in State Tobacco Minimum Legal Sales Age Laws in the US, 2022: A Policy Analysis of State Statutes and Case Laws

by Page D. Dobbs, Ginny Chadwick, Eric Crosbie, Jessica Breslin and Lisa Henriksen

Int. J. Environ. Res. Public Health 2023, 20(11), 6016; https://doi.org/10.3390/ijerph20116016 - 31 May 2023

Viewed by 1289

Abstract

Preemptive statutory language within tobacco minimum legal sales age (MLSA) laws has prohibited localities from enacting stricter laws than state statutes. With the recent uptake of state Tobacco 21 laws in the US, the current landscape of preempted MLSA laws is unknown. This study sought to update the status of preemption in MLSA laws enacted in US states between 2015–2022. A public health attorney reviewed state tobacco MLSA laws (n = 50) and state tobacco control codes, searching for language regarding preemption. When statutes were unclear, case law was reviewed by examining local ordinances that were invalidated by state court decisions. Overall, 40 states enacted Tobacco 21 laws, seven of which expanded or introduced preemption when they increased the MLSA; a total of 26 states (52%) included preemption. Six states (12%) retained ‘savings clauses’ included in the MLSA prior to Tobacco 21, and 18 states (36%) did not mention preemption. Based on the precedent set by state courts, eight of these 18 states may preempt localities from raising their MLSA. Historically, preemption has slowed the diffusion of best practices in tobacco control, and once implemented, the laws are difficult to repeal. The recent expansion of preemption could inhibit the evolution, development, and implementation of effective tobacco control policies. Full article

(This article belongs to the Special Issue Tobacco Control: Challenges, Policies and Interventions)

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14 pages, 540 KiB

Open AccessArticle

Understanding Determinants of Electronic Cigarette and Heated Tobacco Product Use among Young Adults in Lebanon: Prevention and Policy Implications

by Sanaa Mugharbil, Malak Tleis, Maya Romani, Ramzi G. Salloum and Rima Nakkash

Int. J. Environ. Res. Public Health 2023, 20(5), 4273; https://doi.org/10.3390/ijerph20054273 - 28 Feb 2023

Viewed by 1844

Abstract

In line with the global trends, electronic cigarettes (e-cigarettes) and heated tobacco products (HTPs) have found their way to the Lebanese market. The present study aims to explore the determinants of e-cigarette and HTP use among young adults in Lebanon. Convenience and snowball sampling were used to recruit participants aged 18–30 residing in Lebanon, who were familiar with e-cigarettes products. Twenty-one consenting participants were interviewed via Zoom and the verbatim transcriptions were analyzed thematically. The outcome expectancy theory was used to categorize the results into determinants and deterrents of use. HTPs were viewed by participants as another mode of smoking. The results showed that most participants perceived e-cigarettes and HTPs to be healthier alternatives to cigarettes/waterpipes and to be used as smoking cessation tools. Both e-cigarettes and HTPs were found to be easily accessible in Lebanon; although, in the recent economic crisis, e-cigarettes have become unaffordable. More research is needed to investigate the motivations and behaviors of e-cigarette and HTP users if effective policies and regulations are to be developed and enforced. Furthermore, greater public health efforts need to be made to increase awareness of the harmful impacts of e-cigarettes and HTPs and to implement evidence-based cessation programs tailored to those modes of smoking. Full article

(This article belongs to the Special Issue Tobacco Control: Challenges, Policies and Interventions)

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Review

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31 pages, 1309 KiB

Open AccessReview

A Scoping Review of Tobacco Control Health Communication in Africa: Moving towards Involving Young People

by Charity Aienobe-Asekharen, Emma Norris and Wendy Martin

Int. J. Environ. Res. Public Health 2024, 21(3), 259; https://doi.org/10.3390/ijerph21030259 - 23 Feb 2024

Cited by 1 | Viewed by 1382

Abstract

Health communication has been highlighted as a cost-effective preventive intervention in Africa, where the prevalence of tobacco use is still relatively low compared to other World Health Organization (WHO) regions. This scoping review aimed to examine tobacco control health communication interventions in Africa. The review was guided by the PRISMA-ScR checklist. Data was extracted from 20 peer-reviewed papers, WHO Global Health Observatory on anti-tobacco mass-media campaigns for 54 African countries, and 6 WHO Framework Convention on Tobacco Control reports on Article 12. Data extraction informed by the Joanna Briggs Institute (JBI) data-extraction questions was used for peer-reviewed studies while a pre-determined template was used for the other sources. Narrative data synthesis informed by the JBI manual for evidence synthesis was employed. A lack of research that comprehensively addresses all areas of health communication and inconsistent use of health communication campaigns were identified. Only an average of 6 countries had ever implemented high-quality national mass-media campaigns in a decade, while an average of 33 countries consistently failed to conduct campaigns that lasted more than 3 weeks. Although the involvement of key populations was clearly vital to ensure content relevance and message clarity, a lack of health communication informed by young people was observed, as they rarely participated in key decision-making despite reportedly being the targets of interventions. Clear health communication for tobacco-use prevention informed by young people is lacking in African countries. Active participation of young people in developing targeted campaigns is needed to facilitate content relevance and comprehension to ultimately contribute to tobacco-use prevention. Full article

(This article belongs to the Special Issue Tobacco Control: Challenges, Policies and Interventions)

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