Tobacco Control: Policy Development in Developing Countries

First WHO survey of tobacco control policies in the 1970s showed only a handful of developing countries had such policies. However, symbolized by the ratification of the 2003 WHO Framework Convention on Tobacco Control (FCTC), tobacco control has risen onto the institutional agenda of almost all developing countries. I triangulated archival documents with over 200 interviews conducted between 1999 and 2008, and analyzed using Nvivo. Five affects; global, regional, domestic, civil society, and the FCTC explain tobacco control in developing countries. I found that salient affects are global, civil society, and the FCTC. The globalization of tobacco industry made tobacco control a concern of these countries. Until 1990s, civil society groups led diffusion and transfer of tobacco control to these countries. These countries familiarization with knowledge on tobacco use and tobacco control is a reason why tobacco control has ended up on their institutional agendas. However, until the FCTC, participation in governance of tobacco control had little influence on these countries. Domestically, absence of tobacco control policy entrepreneurs and weak civil society means there were little or weak efforts for tobacco control. Regional affects provide the weakest explanation for tobacco control in developing countries. in conclusion, because global, civil society, and the FCTC affects provide the strongest explanation for tobacco control in developing countries, it suggests the need for more research into the activities of tobacco companies and health and socio-economic impacts of tobacco in these countries, civil society capacity building and support, and implementation of the FCTC.