Building tobacco control research in Thailand: meeting the need for innovative change in Asia

Abstract

IntroductionIn low- and middle-income countries (LMICs) over the past two decades locally relevant tobacco control research has been scant. Experience shows that tobacco control measures should be based on sound research findings to ensure that measures are appropriate for local conditions and that they are likely to have an impact. Research should also be integrated within tobacco control measures to ensure ongoing learning and the production of knowledge. Thailand, a middle-income country, has a public health community with a record of successful tobacco control and a longstanding commitment to research. Thailand's comprehensive approach includes taxation; bans on tobacco advertising, sponsorship and promotion; smoke-free areas; graphic cigarette pack warnings; social marketing campaigns; cessation counseling; and an established tobacco control research program. The purpose of this study was to document and analyze the development of tobacco control research capacity in Thailand and the impact of research on Thai tobacco control measures.MethodWe used mixed methods including review of historical documentation and policy reports, qualitative interviews with key members of Thailand's tobacco control community, and an analysis of research productivity.FindingsIn Thailand, tobacco control research has evolved through three phases: (1) discovery of the value of research in the policymaking arena, (2) development of a structure to support research capacity building through international collaborations supported by foreign funding agencies, and (3) delivery of locally relevant research made possible largely through substantial stable funding from a domestic health promotion foundation. Over two decades, Thai tobacco control advocates have constructed five steppingstones to success: (1) adapting foreign research to inform policymaking and lobbying for more support for domestic research; (2) attracting foreign funding agencies to support small-scale research and capacity building; (3) participating in multi-country research and capacity building programs; (4) using collaborative experiences to demonstrate the need for domestic support of locally relevant research; and (5) maintaining an unwavering commitment to research while being vigilant to ensure continued research support.ConclusionThe evolution of tobacco control research in Thailand provides examples of steppingstones that LMICs may be able to use to construct their own tobacco control research pathways.

Examining Implementation of Tobacco Control Policy at the District Level: A Case Study Analysis from a High Burden State in India

“… I think they (government) are not taking it (tobacco control) as a big issue. Tobacco, being a low priority issue, is a concern not only in India but also in many other developing and even developed countries [ 5 , 23 – 25 ]. A study conducted in Australia regarding the translation of the tobacco control policy into practice found that tobacco was considered as a low priority issue and therefore the impact of policy was insignificant [ 26 ].…”

“…Studies from developing [ 30 ] and developed countries [ 25 , 27 ] suggest similar barriers such as shortage of human resource and the shortage of information, education, and communication materials hampering effective implementation of tobacco control policy and program. We (program managers) need funds, manpower, material.…”

Health Taxes on Tobacco, Alcohol, Food and Drinks in Low- and Middle-Income Countries: A Scoping Review of Policy Content, Actors, Process and Context

“…While the WHO was held in high regard for their technical advice, 45,55,60,63,98 sources also highlighted multisectoral consensus building to derive from engagement with the Food and Agriculture Organization (FAO), IMF, the World Bank, and other national and international NGOs and philanthropic trusts. 53,61,62,68,71,73,104,113 Locally-based offices of multilateral agencies, seed organisations and links between multi-lateral actors and local organisations sometimes blurred the boundaries between multilateral and civil society action. Financing and the supplementation of national economic, technical and legal capacities were the predominant forms of support, with each noted to be beneficial in overcoming common LMIC capacity constraints.…”

A Delphi study for setting up tobacco research and practice network in India

“…Studies which assessed factors that impede tobacco control research in low and middle income countries have shown consistently that funding, infrastructure, resources are the most challenging impediments to building up tobacco control research [ 17 – 19 ]. Similarly, in our study experts from all professional affiliations chose funding issues as most important factor impeding formation of tobacco research network in both the rounds of survey.…”