September 12, 2013

Stanton A. Glantz, PhD

First quantitative evidence that the FCTC sped enactment of tobacco control laws (and voluntary industry agreements slowed them)

We just published Effect of the Framework Convention on Tobacco Control and Voluntary Industry Health Warning Labels on Passageof Mandated Cigarette Warning Labels From 1965 to 2012: Transition Probability and Event History Analyses in American Journal of Public Health.
This paper examines the pattern of enactment and strengthening of health warning labels on cigarette packages since 1965, when they were first introduced in the United States.  We found that ratification of the FCTC was associated with a significantly increase in the likelihood that a country would enact or strengthen its warning labels.
We also found that countries that entered into voluntary agreements with the tobacco companies were significantly slowed in their implementation of warning labels.
This is the first quantitative evidence that the FCTC is working to speed the diffusion of tobacco control policies.
Here is the abstract of the paper:
Objectives.We quantified the pattern and passage rate of cigarette package health warning labels (HWLs), including the effect of the Framework Convention on Tobacco Control (FCTC) and HWLs voluntarily implemented by tobacco companies.

Methods. We used transition probability matrices to describe the pattern of HWL passage and change rate in 4 periods. We used event history analysis to estimate the effect of the FCTC on adoption and to compare that effect between countries with voluntary and mandatory HWLs.

Results. The number of HWLs passed during each period accelerated, from a transition rate among countries that changed from 2.42 per year in 1965–1977 to 6.71 in 1977–1984, 8.42 in 1984–2003, and 22.33 in 2003–2012. The FCTC significantly accelerated passage of FCTC-compliant HWLs for countries with initially mandatory policies with a hazard of 1.27 per year (95% confidence interval = 1.11, 1.45), but only marginally increased the hazard for countries that had an industry voluntary HWL of 1.68 per year (95% confidence interval = 0.95, 2.97).
Conclusions. Passage of HWLs is accelerating, and the FCTC is associated with further acceleration. Industry voluntary HWLs slowed mandated HWLs. (Am J Public Health. 
The authors are Ashley N. Sanders-Jackson, Anna V. Song, Heikki Hiilamo, and Stanton A. Glantz.

The full paper is available at

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