CoChat
Sign Up
Cited by 47Global Public Health Policies and EpidemiologySmoking Behavior and CessationPublic Health Policies and Education

The importance of continued engagement during the implementation phase of tobacco control policies in a middle-income country: the case of Costa Rica

Open access
Crosbie, Eric, Sosa, Patricia, Glantz, Stanton A·2017·Tobacco Control
DOI 10.1136/tobaccocontrol-2015-052701PMC PMC4977207
Open this paper in CoChat — free account

Abstract

OBJECTIVE: To analyse the process of implementing and enforcing smoke-free environments, tobacco advertising, tobacco taxes and health warning labels from Costa Rica's 2012 tobacco control law. METHOD: Review of tobacco control legislation, newspaper articles and interviewing key informants. RESULTS: Despite overcoming decades of tobacco industry dominance to win enactment of a strong tobacco control law in March 2012 consistent with WHO's Framework Convention on Tobacco Control, the tobacco industry and their allies lobbied executive branch authorities for exemptions in smoke-free environments to create public confusion, and continued to report in the media that increasing cigarette taxes led to a rise in illicit trade. In response, tobacco control advocates, with technical support from international health groups, helped strengthen tobacco advertising regulations by prohibiting advertising at the point-of-sale (POS) and banning corporate social responsibility campaigns. The Health Ministry used increased tobacco taxes earmarked for tobacco control to help effectively promote and enforce the law, resulting in high compliance for smoke-free environments, advertising restrictions and health warning label (HWL) regulations. Despite this success, government trade concerns allowed, as of December 2015, POS tobacco advertising, and delayed the release of HWL regulations for 15 months. CONCLUSIONS: The implementation phase continues to be a site of intensive tobacco industry political activity in low and middle-income countries. International support and earmarked tobacco taxes provide important technical and financial assistance to implement tobacco control policies, but more legal expertise is needed to overcome government trade concerns and avoid unnecessary delays in implementation.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1136/tobaccocontrol-2015-052701

Cites

67 of 67 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • The WHO FCTC establishes evidence-based standards for tobacco control that provide a framework in which tobacco control advocates can play significant roles in securing comprehensive national tobacco control policies.

    “WHO Framework Convention on Tobacco Control1 (FCTC) establishes evidence-based standards for tobacco control that provide a framework in which tobacco control advocates can play significant roles in securing comprehensive national tobacco control policies.2–6”

    From Role of stakeholders in Nigeria’s tobacco control journey after the FCTC: lessons for tobacco control advocacy in low-income and middle-income countries (2019) · cites this paper as [6]

    The Introduction says the FCTC accelerated tobacco-control legislation and that Costa Rican advocates persuaded legislators to enact a comprehensive law implementing it. The Results (Tobacco taxes) also describes FCTC implementation guidelines and protocols. These passages support the framework and advocacy portions, but our copy does not characterize the FCTC’s standards as evidence-based. Page numbers are unavailable in our copy. (LLM, conf=0.83)

    Experimental — accuracy not yet measured

  • Unlike other countries, the Uruguayan congress did not attempt to weaken the regulations.

    “This assistance proved critical because unlike other countries,55–57 congress did not attempt to weaken the regulations.49–51”

    From Defending strong tobacco packaging and labelling regulations in Uruguay: transnational tobacco control network versus Philip Morris International (2018) · cites this paper as [57]

    The Discussion reports attempts in Costa Rica and other countries to weaken tobacco-control regulations by seeking exemptions during implementation. It does not say that congress in those countries attempted to weaken the regulations; the Costa Rican account instead describes lobbying during an executive-branch regulatory process. The statement about Uruguay is attached to separate citations and is not assessed here. (LLM, conf=0.82)

    Experimental — accuracy not yet measured

  • Similar to successful tobacco control advocacy efforts in other countries, local civil society groups developed close relationships with government officials, provided evidence-based information to policy-makers, and closely monitored swift government actions and industry activity to advance tobacco control in Uruguay.

    “Similar to successful tobacco control advocacy efforts in other countries,17579293 local civil society groups developed close relationships with government officials, provided evidence-based information to policy-makers, and closely monitored swift government actions and industry activity to advance tobacco control in Uruguay.”

    From Defending strong tobacco packaging and labelling regulations in Uruguay: transnational tobacco control network versus Philip Morris International (2018) · cites this paper as [57]

    Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.

    Experimental — accuracy not yet measured

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

5 of the 72 references couldn’t be matched to a known paper.

Research works printed but not linked: 4

  1. [18]Crosbie E Sosa P Glantz SA Costa Rica's Successful Implementation of the FCTC Salud Publica Mex 2015 In press PMC4758506 26879509
  2. [47]World Health Organization Conference of the Parties to the WHO Framework Convention on Tobacco Control Decision: Electronic nicotine delivery systems and electronic non-nicotine delivery systems 18 10 2014 Moscow Russian Federation
  3. [99]Chapman S Advocacy in action: extreme corporate makeover interruptus: denormalising tobacco industry corporate schmoozing Tob Control 2004 13 445 7 15564635 PMC1747945
  4. [107]Cavalcante T Carvalho Ade M Social responsibility argument for the tobacco industry in Brazil Salud Publica Mex 2006 48 Suppl 1 S173 182 17684681

Cited by

Sorted by citations

Related

Authors
Crosbie, E., Sosa, P., & Glantz, S. A.
Affiliations
University of California, San Francisco (US)
Corresponding author
Glantz, Stanton A
ORCID
Venue
Tobacco Control
Publisher
BMJ
Published
2016-02-08
Volume
26
Issue
1
Pages
60-68
ISSN
  • 0964-4563 (ISSN-L)
  • 1468-3318
DOI
10.1136/tobaccocontrol-2015-052701
PMC
PMC4977207
OpenAlex
W2305316725
Cited by
47
References
72
Citations by year
2026: 1 · 2025: 4 · 2024: 2 · 2023: 6 · 2022: 3 · 2021: 7 · 2020: 5 · 2019: 7 · 2018: 6 · 2017: 3 · 2016: 2 · 2015: 1
FWCI
11.66
Type
journal article
Language
en
Open access
Locations
  • Tobacco Control (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
  • HighWire Press Open Archive (submittedVersion)
Funders
  • Philip Morris International
  • University of California, San Francisco
  • National Cancer Institute (R01CA087472)
Topics
  • Social Sciences › Business, Management and Accounting › Organizational Behavior and Human Resource Management › Global Public Health Policies and Epidemiology
  • Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
  • Health Sciences › Health Professions › General Health Professions › Public Health Policies and Education
Keywords
tobacco control policy implementation, smoke-free areas, tobacco advertising regulation, tobacco taxation, health warning labels, tobacco control legislation, tobacco industry lobbying, Framework Convention on Tobacco Control, illicit tobacco trade, Costa Rica
MeSH terms
Smoking Prevention, Advertising, Commerce, Costa Rica, Health Policy, Humans, Lobbying, Product Labeling, Social Responsibility, Taxes, Tobacco Industry, Smoke-Free Policy, Tobacco Products

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review