February 8, 2016

Stanton A. Glantz, PhD

Costa Rica: The importance of continued engagement when implementing tobacco control policies in a middle-income country

Eric Crosbie, Patricia Sosa, and I just published "The importance of continued engagement during the implementation phase of tobacco control policies in a middle-income country: the case of Costa Rica" in Tobacco Control.
 
This paper is the third in a series of papers tracking the development of tobacco control in Costa Rica.  While a small country, Costa Rica is a trend setter in many public policies in Latin America.  The first paper, "Tobacco industry success in Costa Rica: the importance of FCTC article 5.3," (Spanish translation) showed that the tobacco industry understood this fact and, successfully,  prioritized blocking passage of tobacco control legislation for decades.  The second, "Costa Rica’s implementation of the Framework Convention on Tobacco Control: Overcoming decades of industry dominance" (Spanish version), showed how, with support from international tobacco contol advocates, Costa Rica public health advocates won ratification of the FCTC and passed strong implementing legislation. (We also published a more detailed version through the UC eScholarship initiative, which is available here.)
 
This third paper completes the story by showing how, with continued international support, Costa Rican public health advocates were able to overcome continuing industry efforts to block successful implementation of the law.  These papers demonstrate that, with a little help, even small countries can stand up to Big Tobacco.  It also highlights the big payoffs for modest investments in supporting aggressive tobacco control.
 
Eric prepared excellent short videos in English and Spanish summarizing the study.  Check them out.
 
Here is the abstract:
 
Objective To analyse the process of implementing and enforcing smoke-free environments, tobacco advertising, tobacco taxes and health warning labels from Costa Rica’s 2012 tobacco control law.

Method Review of tobacco control legislation, newspaper articles and interviewing key informants.
 
Results Despite overcoming decades of tobacco industry dominance to win enactment of a strong tobacco control law in March 2012 consistent with WHO’s Framework Convention on Tobacco Control, the tobacco industry and their allies lobbied executive branch authorities for exemptions in smoke-free environments to create public confusion, and continued to report in the media that increasing cigarette taxes led to a rise in illicit trade. In response, tobacco control advocates, with technical support from international health groups, helped strengthen tobacco advertising regulations by prohibiting advertising at the point-of-sale (POS) and banning corporate social responsibility campaigns. The Health Ministry used increased tobacco taxes earmarked for tobacco control to help effectively promote and enforce the law, resulting in high compliance for smokefree environments, advertising restrictions and health warning label (HWL) regulations. Despite this success, government trade concerns allowed, as of December 2015, POS tobacco advertising, and delayed the release of HWL regulations for 15 months.
 
Conclusions The implementation phase continues to be a site of intensive tobacco industry political activity in low and middle-income countries. International support and earmarked tobacco taxes provide important technical and financial assistance to implement tobacco control policies, but more legal expertise is needed to overcome government trade concerns and avoid unnecessary delays in implementation.

Add new comment

Plain text

  • No HTML tags allowed.
  • Web page addresses and e-mail addresses turn into links automatically.
  • Lines and paragraphs break automatically.