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A health policy analysis of the implementation of the National Tobacco Control Act in Nigeria
Open accessAbstract
Non-communicable diseases (NCDs) have emerged as a public health issue of concern in Nigeria. The massive increase in tobacco use amongst different population groups is a common NCDs risk factor. To this effect, the National Tobacco Control Act (NTCA) was enacted following the WHO Framework Convention on Tobacco Control (FCTC). This article conducts a health policy agenda-setting analysis of the NTCA using the Kingdon’s multiple streams model and analyses its implementation using the Principal-Agent theory. The purposive and snowballing sampling methods were used to select and review relevant peer-review literature. Other data sources included gray literature, government reports, Non-Governmental Organization briefs and media resources. Though NTCA conforms to WHO FCTC, Nigeria only domesticated her obligation to this framework legislatively while the executive and administrative measures were found lacking. The challenges and gaps identified in the NTCA implementation include; revision of textual health warnings and lack of pictorial health warnings on cigarette packs, poor taxation, and the National Tobacco Control Commission’s (NTCC) lack of regulatory autonomy, hence, the poor policy implementation reported in this article. To effectively implement NTCA, a review of textual warnings, enforcement of pictorial warnings, regulatory autonomy of the NTCC and review of the tobacco taxation are suggested to help in the prevention and control of NCDs.
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Few studies have explored how tobacco control policy change comes about, particularly in LMICs and on tobacco tax policy.
“Unfortunately, few studies have explored how tobacco control policy change comes about, particularly in the context of low-income and middle-income countries (LMICs) and on the topic of tobacco tax policy.20–24”
From Seven-year tobacco tax plan in Ukraine: a case study of the actors, tactics and factors motivating policy passage (2022) · cites this paper as [24]
The Methods section reports a paucity of documents and peer-reviewed articles on tobacco control policy in Nigeria, and describes examining how that policy developed. It does not establish that such studies are scarce across LMICs or specifically on how tobacco tax policy changes. (LLM, conf=0.84)
Experimental — accuracy not yet measuredPowerful actors in countries across the globe and across industries threatened by policy change similarly use lobbying to water down policy to their benefit, sometimes behind closed doors.
“Additionally, like the tobacco industry in Ukraine, powerful actors in countries across the globe and across industries threatened by policy change similarly use lobbying to water down policy to their benefit, sometimes behind closed doors.20–22 24–26 28 33 34 63–65”
From Seven-year tobacco tax plan in Ukraine: a case study of the actors, tactics and factors motivating policy passage (2022) · cites this paper as [24]
The Politics stream describes British American Tobacco’s efforts to influence Nigerian parliamentarians and weaken or stop tobacco-control legislation. That supports the claim’s core example of an industry actor seeking to blunt policy change, but the paper does not establish the broader assertion across countries and industries or specifically describe lobbying behind closed doors. (LLM, conf=0.84)
Experimental — accuracy not yet measuredHighlighting the economic cost of tobacco use, as well as framing policy as a health measure, is consistent with the strategy used in Nigeria to pass their national tobacco control act.
“Highlighting the economic cost of tobacco use, as well as framing policy as a health measure, is consistent with the strategy used in Nigeria to pass their national tobacco control act.24”
From Seven-year tobacco tax plan in Ukraine: a case study of the actors, tactics and factors motivating policy passage (2022) · cites this paper as [24]
The importance of the EU-UAA as a motivating factor driving policy adoption fits within the literature highlighting how the FCTC and Master Settlement Agreement have also motivated tobacco policy.
“The importance of the EU-UAA as a motivating factor driving policy adoption fits within the literature highlighting how the FCTC and Master Settlement Agreement have also motivated tobacco policy.24 66 67”
From Seven-year tobacco tax plan in Ukraine: a case study of the actors, tactics and factors motivating policy passage (2022) · cites this paper as [24]
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Cites
Exposing and addressing tobacco industry conduct in low-income and middle-income countries
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Weiger, C., Hoe, C., & Cohen, J. E. (2022) · BMJ Open · doi:10.1136/bmjopen-2021-049833 · Cited by 10
Metadata
- Authors
- Udokanma, E. E., Ogamba, I., & Ilo, C.
- Affiliations
- University College London (GB)
- Coventry University (GB)
- Ebonyi State University (NG)
- Corresponding author
- Udokanma, Echezona Ejike
- Venue
- Health Policy and Planning
- Publisher
- Oxford University Press (OUP)
- Published
- 2021-01-04
- Volume
- 36
- Issue
- 4
- Pages
- 484-492
- ISSN
- 0268-1080 (ISSN-L)
- 1460-2237
- OpenAlex
- W3119197472
- Cited by
- 17
- References
- 1
- Citations by year
- 2026: 4 · 2025: 6 · 2024: 3 · 2023: 3 · 2022: 1
- FWCI
- 0.21
- Type
- journal article
- Language
- en
- Open access
- Licence
- Locations
- Health Policy and Planning (publishedVersion)
- PubMed (publishedVersion)
- Pure (Coventry University) (submittedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Global Public Health Policies and Epidemiology
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Smoking Behavior and Cessation
- Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
- Keywords
- tobacco control, policy implementation, Framework Convention on Tobacco Control, Kingdon's multiple streams model, agency theory, graphic health warnings, tobacco taxation, regulatory independence, non-communicable diseases, Nigeria
- MeSH terms
- Smoking Prevention, Female, Health Policy, Humans, Nigeria, Policy Making, Nicotiana, World Health Organization, Tobacco Industry, Tobacco Products, Tobacco Use
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