Tobacco control in Nepal during a time of government turmoil (1960-2006)

Dharma Bhatta, Eric Crosbie, Stella Bialous and I just published “Tobacco control in Nepal during a time of government turmoil (1960-2006)” in Tobacco Control. This paper describes early tobacco control efforts in Nepal and shows how, even in exceptionally difficult political circumstances, it is possible to make progress on tobacco control.  The Nepalese advocates also made creative use of litigation to advance their efforts.

What is already known on this subject

► The tobacco industry influences tobacco control policy in low-income and middle-income countries (LMICs) by taking advantage of low state capacity, unstable governments and corruption.

► Most litigation on tobacco control in LMICs has been initiated by the tobacco companies to block regulation.

What this paper adds

►In Nepal, political instability or conflict, direct investment on tobacco business by royal family members and the dictatorship had significant negative effects on tobacco control.

►Involvement in international activities, such as World No Tobacco Day, created opportunities for Nepalese tobacco control advocates to press government for change.

►Civil society groups in Nepal sued the government and tobacco companies in the Supreme Court to win bans on smoking in public places and tobacco advertising, promotions and sponsorship, a model that could be used in other LMICs

Here is the abstract:

Background Nepal was a monarchy, then a dictatorship, then a democracy. This paper reviews how tobacco control progressed in Nepal in the context of these changes in government from 1950 through 2006.

Methods We triangulated tobacco industry documents, newspaper articles and key informant interviews.

Results Until 1983, the tobacco industry was mostly state owned. Transnational tobacco companies entered the Nepalese market through ventures with Surya Tobacco Company Private Limited (with Imperial Tobacco Company and British American Tobacco) in 1983 and Seti Cigarette Factory Limited (with Philip Morris International [PMI]) in 1985. Seminars and conferences on tobacco, celebrations of World No Tobacco Day (WNTD) and efforts by WHO helped promote tobacco control in Nepal beginning in the 1970s. Tobacco advocates in Nepal pushed the government to issue executive orders banning smoking in public places in 1992 and tobacco advertising in electronic media in 1998, and to introduce a tobacco health tax in 1993.  The tobacco industry lobbied against these measures and succeeded in keeping the tobacco tax low by challenging it in court. Tobacco advocates sued the government in 2003 and 2005, resulting in a June 2006 Supreme Court decision upholding the smoking and advertising bans and requiring the government to enact a comprehensive tobacco control law.

Conclusions Political instability, conflict, weak governance and the dictatorship significantly affect tobacco control activities in low-income and middle income countries. Nepal shows that tobacco control advocates can take advantage of global events, such as WNTD, and use domestic litigation to maintain support from civil societies and to advocate for stronger tobacco control policies.

The full citation is Bhatta D, Crosbie E, Bialous S, Glantz S.  Tobacco control in Nepal during a time of government turmoil (1960-2006).  Tob Control 2019; Epub before print. doi:10.1136/tobaccocontrol-2019-055066.  It is available here.