Norms, rules and policy tools: understanding Article 5.3 as an instrument of tobacco control governance

Abstract

IntroductionArticle 5.3 of the WHO Framework Convention on Tobacco Control, elaborated via its implementation guidelines, can be understood as a policy instrument comprising norms, rules and policy tools designed to shape practices of policy making and minimise tobacco industry interference.MethodsThis qualitative research is based on in-depth interviews with officials from diverse government sectors and non-governmental organisations across countries (Ethiopia, India, Uganda) that have adopted measures to implement Article 5.3.ResultsThe data highlight varied perceptions and knowledge of Article 5.3 norms between health and non-health sectors. Health officials typically link its core norm of a fundamental conflict between public health and industry interests to the governance norm of protecting public health policies from industry interference. While officials in sectors beyond health broadly endorsed this core norm, they exhibited more limited awareness of Article 5.3 and its model of governance. The results examine how rules to implement Article 5.3 have been codified, but identify the absence of policy tools necessary to operationalise rules and norms. This limitation, alongside restricted awareness beyond health departments, suggests that political commitments to implement Article 5.3 will have limited impact on practices of stakeholder consultation and policy engagement with the tobacco industry.ConclusionConceptualising Article 5.3 as a policy instrument helps to explain how its rules and policy tools interact with each other and with broader governance processes. This framework has the potential to enhance understanding of Article 5.3 and help identify opportunities and constraints in its implementation.

Tobacco policy (in)coherence in Mozambique: an examination of national and subnational stakeholder perspectives

“…These perspectives may present challenges to Article 17 implementation, because in contexts where tobacco production is viewed as an economic commodity, mechanisms are often in place to support tobacco growing (Smith and Fang, 2020a ). Moving away from tobacco as an economic commodity is not simply limited to farm-level changes in the type of crop grown, but a deeper shift in the institutional environment ( Lencucha and Thow, 2020 ; Fooks et al , 2017 , 2022 ; Ralston et al ., 2022 ).…”

“…However, the extensive research on Article 5.3 of the FCTC, which highlights the need for parties to limit industry interference, indicates the need to insulate government from industry influence is paramount. The integration of the norms, rules and tools associated with Article 5.3 can contribute to shifts away from the narrative that tobacco brings prosperity, but reorienting who participating in the priority setting initiatives of governments ( Hirpa et al ., 2022 ; Ralston et al ., 2022 ).…”

“…Policy incoherence in tobacco control is common across sectors, reflected in part by conflicting mandates ( Bump and Reich, 2013 ; Abdullah et al ., 2022 ; Ralston et al ., 2022 ). This is particularly common in countries where tobacco is grown.…”

Addressing tobacco industry influence in tobacco-growing countries

“…Article 5.3 is a policy instrument within the FCTC, designed to protect policy-making from commercial and other vested interests of the tobacco industry. 41 Within the general obligations of Article 5.3, the guidelines call on all departments within government to be accountable to the principles that protect tobacco control from industry influence. For instance, the guidelines state that “Any government branch (executive, legislative and judiciary) responsible for setting and implementing tobacco control policies and for protecting those policies against tobacco industry interests should be accountable.” 42…”

Manejo de conflictos de interés en control del tabaco: situación en las Américas

“…En efecto, dado que esta puede darse en diferentes ámbitos de la política de control del tabaco, el artículo 5.3 es considerado como una de las "columnas vertebrales" del Convenio (7). En efecto, el éxito del resto de las medidas del CMCT dependen en gran medida de los resguardos que los Estados Parte implementen para proteger sus políticas de control del tabaco de la influencia de la industria (7)(8)(9). En ese sentido, la protección de políticas públicas de salud de los conflictos de interés requiere necesariamente enfrentar los desafíos que dichos conflictos presentan a legisladores y reguladores, fomentándose la adopción de prácticas que promuevan relaciones transparentes, responsables, y desprovistas de cualquier interés privado con los diversos actores que pretenden intervenir en el proceso de diseño, adopción e implementación de políticas públicas (10,11).…”