Role of stakeholders in Nigeria’s tobacco control journey after the FCTC: lessons for tobacco control advocacy in low-income and middle-income countries

Catherine Egbe, Stella Bialous, and I just published “Role of stakeholders in Nigeria’s tobacco control journey after the FCTC: lessons for tobacco control advocacy in low-income and middle-income countries” in Tobacco Control. 

The paper shows that Framework Convention on Tobacco Control (FCTC) ratification has not stopped the tobacco industry from using its well-established tactics to stall tobacco control policy in Nigeria.  We used the Policy Dystopia Model and WHO categories of tobacco industry interference provide a helpful framework for analysing and understanding the activities of the tobacco industry and of tobacco control advocates in Nigeria.  Despite strong resistance from the tobacco companies, tobacco control advocates were able to make some progress, particularly because they were assisted with international technical support and funding.  These lessons from Nigeria are transferable and adaptable for other low-income and middle-income countries and African countries.

This is our third paper on the evolving history of tobacco control policymaking in Nigeria and, to get the most out of this new paper, it should be read in the context of the two earlier papers, which provide the historical foundation for this one:

“Avoiding “A Massive Spin-Off Effect in West Africa and Beyond”: The Tobacco Industry Stymies Tobacco Control in Nigeria” that uses tobacco industry documents to show how the tobacco industry to show how BAT and other tobacco companies blocked development and implementation of Nigeria’s first tobacco control law in the 1990s. 

“FCTC Implementation in Nigeria: Lessons for Low and Middle-Income Countries.” Describes the enactment of Nigeria’s 2015 National Tobacco Control Act and how, while an improvement over the earlier law, the tobacco companies secured the unprecedented step of requiring approval of implementing regulations for the Nigerian law, which has slowed implementation and should not be allowed to become a precedent in other countries.

Here is the abstract for the new paper:

Introduction Nigeria ratified the WHO Framework Convention on Tobacco Control (FCTC) in 2005.  Tobacco control advocates in Nigeria achieved some success in countering tobacco industry interference to implement the FCTC.

Methods We triangulated interviews with key informants from local and international organisations who worked in Nigeria with documentation of the legislative process and Nigerian newspaper articles.  Data were analysed and interpreted using the Policy Dystopia Model and WHO categories of tobacco industry interference that had been developed mostly based on experience in high-income countries.

Results As in high-income countries, the tobacco industry continued to oppose tobacco control policies after Nigeria ratified the FCTC, including weakening Nigeria’s 2015 National Tobacco Control Act. Both tobacco control advocates and industry used discursive (argument-based) and instrumental (activity-based) strategies. The industry argued self-regulation and the economic importance of tobacco. They exploited legislative procedures, used front groups and third parties to push for pro-industry changes. Advocates, with help from international organisations, mobilized prominent Nigerians and the public. Advocates preempted and countered the industry through traditional and social media, monitoring and exposing tobacco industry activities, and by actively engaging lawmakers and citizens during the legislative process.

Conclusion: The Policy Dystopia Model and WHO categories of industry interference provide a helpful framework for understanding tobacco control debates in low/middle-income countries (LMICs) as in high-income countries. One difference in LMIC is the important role of international tobacco control advocates in supporting national tobacco control advocates. This partnership is important in pushing for FCTC-compliant legislation and countering industry activities in LMIC.

The full citation is Egbe CO, Bialous SA, Glantz S. Role of stakeholders in Nigeria’s tobacco control journey after the FCTC: lessons for tobacco control advocacy in low-income and middle-income countries.  Tob Control Epub ahead of print 25 Jul 2018.  doi:10.1136/tobaccocontrol-2018-054344.  It is available for free here.