Tobacco control faces a most daunting foe in an enormous, highly-profitable, and politically well-connected tobacco industry driven to expand its customer base to maximize profits. However, there are proactive steps that the tobacco control community can take to counter the industry and maximize public health goals.
Preparation. One of the best strategies is to plan for the industry’s inevitable pushback against any tobacco control effort that is likely to reduce their customer base – i.e., think before the implementation of an intervention. The tobacco industry typically employs the same set of strategies to fight against tobacco control efforts, no matter the time or place. For example, the industry continues to litigate against tobacco control policies in courts across the world, including claims that measures violate commitments to international economic agreements. Anticipating that the industry would challenge their plain, standardized tobacco packaging initiative, Australia’s health ministry worked in advance with its trade and foreign affairs counterparts to develop policy that would withstand scrutiny in trade dispute settlement, including in the World Trade Organization.
Capacity. Effective tobacco control needs a variety of established professional skill sets, including economics, law, medicine, public health, social science, and communications to successfully execute policies and programs. For the countries lower on the Human Development Index, this will almost certainly mean some resource assistance, peer guidance, and targeted educational development from external supporters. The tobacco control community must escalate the engagement of appropriate professionals to outpace the industry’s own hired experts.
Accountability. Governments must be accountable to their citizens, which includes ensuring overall societal well-being. Actively pursuing the straightforward obligations and recommendations of the WHO FCTC— including allocating sufficient resources to these efforts— will contribute to improved tobacco control, and therefore, greater societal well-being. The return on investment from tobacco control in lower health costs and increased productivity is enormous. Reliable and consistent measuring of progress can help to increase accountability.
Transparency. With near-constant pressure from the tobacco industry, governments must implement policies consistent with WHO FCTC Article 5.3 to make any interactions with the tobacco industry completely transparent— a crucial component of accountability. Moreover, the tobacco industry must have no place in shaping health policy or any policies that are likely to have health effects.
Multi-sectoral approach. As enshrined in WHO FCTC Article 5.2(a), for tobacco control to work more effectively, different sectors must work together. In the case of tobacco taxation, finance ministries must work with health counterparts to better understand how tax policy can maximize both revenues and health impacts. Health ministries are generally the natural tobacco control focal point, but they must understand their peer departments, and work to educate and empower them to vigorously promote tobacco control. Beyond government, civil society can help to pressure governments for better tobacco control and provide independent expertise, while the research sector can help to build tobacco control’s evidence base.