Improving the implementation of tobacco control policies in low-and middle-income countries: a proposed framework
Open accessAbstract
► Although tobacco control policies have been adopted across the globe, effective implementation continues to be a major challenge, particularly in low-income and middle-income countries, where almost 80% of the world's smokers reside.► This conceptual framework illustrates the constellation of factors that have been shown to influence implementation fidelity: political commitment, institutional capacity and operational effectiveness, social climate and tobacco industry interference.► Researchers and practitioners can use this framework to identify the points of leverage in the implementation process and contribute to actionable knowledge as well as theory development.
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Low awareness of the full society-wide harms of tobacco reinforces barriers to implementation, particularly in LMICs facing or at risk of high burdens.
“Reinforcing these barriers is low awareness of the full, society-wide harms of tobacco, particularly in LMICs facing or at risk of high burdens.19”
From Advancing progress on tobacco control in low-income and middle-income countries through economic analysis (2024) · cites this paper as [19]
The framework’s social-climate discussion (page not available in our copy) links public awareness and education to effective tobacco-control implementation, and its introduction identifies LMICs as facing particular implementation challenges. It does not say that awareness of tobacco’s full society-wide harms is low or identify that specific lack of awareness as a barrier. (LLM, conf=0.82)
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Cites
A conceptual framework for implementation fidelity
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Exposing and addressing tobacco industry conduct in low-income and middle-income countries
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Hiilamo, H., & Glantz, S. A. (2015) · Social Science & Medicine · doi:10.1016/j.socscimed.2014.11.054 · Cited by 58 · see citing works
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Cited by
Sorted by citations
Small, R., Nugent, R., Webb, D., Hutchinson, B., Spencer, G., Ngongo, C., Chestnov, R., & Tarlton, D. (2024) · Tobacco Control · doi:10.1136/tc-2023-058335 · Cited by 14 · see citing works
- Authors
- Hoe, C., Kennedy, R. D., Spires, M., Tamplin, S., & Cohen, J. E.
- Affiliations
- Johns Hopkins University (US)
- Corresponding author
- Hoe, Connie
- Venue
- BMJ Global Health
- Publisher
- BMJ
- Published
- 2019-12
- Volume
- 4
- Issue
- 6
- Pages
- e002078
- ISSN
- 2059-7908 (ISSN-L)
- PMC
- PMC6936550
- OpenAlex
- W2996740554
- Cited by
- 23
- References
- 3
- Citations by year
- 2026: 1 · 2025: 7 · 2024: 5 · 2023: 1 · 2022: 5 · 2021: 3 · 2019: 1
- FWCI
- 1.54
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by-nc
- Locations
- BMJ Global Health (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Greenwich Academic Literature Archive (University of Greenwich) (acceptedVersion)
- City Research Online (City University London) (acceptedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Bloomberg Family Foundation
- Topics
- Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
- Social Sciences › Business, Management and Accounting › Organizational Behavior and Human Resource Management › Global Public Health Policies and Epidemiology
- Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
- Keywords
- tobacco control, policy implementation, implementation fidelity, low- and middle-income countries, political commitment, institutional capacity, operational effectiveness, social climate, tobacco industry interference, conceptual framework
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