Accelerated Adoption of Smoke-Free Laws After Ratification of the World Health Organization Framework Convention on Tobacco Control
Open accessAbstract
Objectives. We sought to evaluate the effect of ratifying the World Health Organization Framework Convention on Tobacco Control (FCTC) on countries enacting smoke-free laws covering indoor workplaces, restaurants, and bars. Methods. We compared adoption of smoke-free indoor workplace, restaurant, and bar laws in countries that did versus did not ratify the FCTC, accounting for years since the ratification of the FCTC and for countries’ World Bank income group. Results. Ratification of the FCTC significantly (P < .001) increased the probability of smoke-free laws. This effect faded with time, with a half-life of 3.1 years for indoor workplaces and 3.8 years for restaurants and bars. Compared with high-income countries, upper-middle–income countries had a significantly higher probability of smoke-free indoor workplace laws. Conclusions. The FCTC accelerated the adoption of smoke-free indoor workplace, restaurant, and bar laws, with the greatest effect in the years immediately following ratification. The policy implication is that health advocates must increase efforts to secure implementation of FCTC smoke-free provisions in countries that have not done so.
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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 [67]
The transnational tobacco control network supported the creation of the WHO FCTC and assisted governments in implementing it, which has accelerated the adoption of tobacco control regulations, including pictorial health warning labels on cigarette packages.
“This network supported the creation of the WHO Framework Convention on Tobacco Control (FCTC)15 and assisted governments in implementing it,16–19 which has accelerated the adoption of tobacco control regulations,20–23 including pictorial health warning labels (HWLs) on cigarette packages.24”
From Defending strong tobacco packaging and labelling regulations in Uruguay: transnational tobacco control network versus Philip Morris International (2018) · cites this paper as [22]
Properly implemented FCTC policies significantly reduce tobacco consumption.
“Properly implemented FCTC policies significantly reduce tobacco consumption.7–10”
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 [10]
The Results report that FCTC ratification significantly increased the probability of adopting smoke-free laws, while the Abstract discusses reduced exposure to secondhand smoke. Neither passage establishes that implementing FCTC policies significantly reduces tobacco consumption; a search for consumption and smoking prevalence found no such finding in our copy. (LLM, conf=0.76)
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Cites
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Gravely, S., Giovino, G. A., Craig, L., Commar, A., D'Espaignet, E. T., Schotte, K., & Fong, G. T. (2017) · The Lancet Public Health · doi:10.1016/s2468-2667(17)30045-2 · Cited by 260 · see citing works
Crosbie, E., Sosa, P., & Glantz, S. A. (2018) · Tobacco control · doi:10.1136/tobaccocontrol-2017-053690 · Cited by 96 · see citing works
Self-citationCrosbie, E., Sosa, P., & Glantz, S. A. (2017) · Tobacco Control · doi:10.1136/tobaccocontrol-2015-052701 · Cited by 47 · see citing works
Self-citationEgbe, C. O., Bialous, S. A., & Glantz, S. (2019) · Tobacco Control · doi:10.1136/tobaccocontrol-2018-054344 · Cited by 31 · see citing works
Self-citationWeiger, C., Hoe, C., & Cohen, J. E. (2022) · BMJ Open · doi:10.1136/bmjopen-2021-049833 · Cited by 10 · see citing works
- Authors
- Uang, R., Hiilamo, H., & Glantz, S. A.
- Affiliations
- University of Helsinki (FI)
- Venue
- American Journal of Public Health
- Publisher
- American Public Health Association
- Published
- 2016-01
- Volume
- 106
- Issue
- 1
- Pages
- 166-171
- ISSN
- 0090-0036 (ISSN-L)
- 1541-0048
- PMC
- PMC4689638
- OpenAlex
- W2124867385
- Cited by
- 47
- References
- 1
- Citations by year
- 2026: 2 · 2025: 5 · 2024: 4 · 2023: 3 · 2022: 5 · 2021: 3 · 2020: 2 · 2019: 5 · 2018: 10 · 2017: 4 · 2016: 4
- FWCI
- 4.42
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- American Journal of Public Health (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- Funders
- World Bank Group
- National Cancer Institute (R01CA087472, CA 87472)
- 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 › Public Health Policies and Education
- Keywords
- smoking bans, Framework Convention on Tobacco Control, tobacco control, international health law, policy adoption
- MeSH terms
- Cross-Cultural Comparison, Developing Countries, Humans, Restaurants, Tobacco Smoke Pollution, Global Health, World Health Organization, Proportional Hazards Models, Workplace, Developed Countries
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