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Special Issue "The Political Economy of Global Tobacco Control: Understanding Tobacco Supply"

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Economics".

Deadline for manuscript submissions: closed (31 October 2020).

Special Issue Editors

Dr. Raphael Lencucha
E-Mail Website
Guest Editor
Faculty of Medicine, School of Physical and Occupational Therapy, McGill University, Montreal, QC 3605, Canada
Interests: tobacco control; public policy; institutions; political economy; tobacco supply; tobacco farming
Dr. Jeffrey Drope
E-Mail Website
Guest Editor
American Cancer Society, Atlanta, USA
Interests: tobacco control; non-communicable disease; political economy; economic development

Special Issue Information

Dear Colleagues,

Tobacco use remains one of the leading causes of noncommunicable disease. Tobacco use stems from the relentless promotion of tobacco products by strategic, well-organized, and deeply-resourced transnational tobacco companies. These companies have established elaborate international supply chains to move tobacco leaf from farm to manufacturing to retail with the ultimate aim of maximizing profits at the expense of human health. What is deeply troubling from a public health perspective is the way that tobacco companies have established effective strategies to embed their economic interests into the policy landscape of countries; particularly those countries where tobacco is grown and manufactured. This relationship to public policy is made more problematic by narratives that assert the benefits of tobacco to the lives of tobacco producers, particularly at the beginnings of the production chain, such as tobacco farmers, and the wider economy. Layered into the relationship between the tobacco industry and public institutions are ideas about economic development that make policy makers receptive to these narratives. This institutional and policy landscape makes it exceptionally difficult for policy makers to establish and implement comprehensive policy measures that address both tobacco supply and demand. There is a critical need to deepen our understanding of the strategies used by tobacco interests to shape this landscape. Additionally, there is a need to understand how ideas (e.g., economic development, norms pertaining to the relationships between private and public entities), institutions (e.g., the rules, norms, and strategies that shape the development and implementation of public policy and programs) and interests foster or hinder movement towards comprehensive tobacco control measures with specific emphasis on the often neglected dimension of tobacco supply.

This Special Issue welcomes research and scholarship on the political economy of global tobacco control with an emphasis on tobacco supply. We welcome historical analyses that trace changes over time as well as analysis of current contexts. This Special Issue will place specific emphasis on the following topics:

  1. Policy process (e.g., how have tobacco interests affected the policy process, what levers (e.g., information, arguments, narratives, rules, norms) are utilized during the policy process to resist or support policies that seek alternatives to tobacco);
  2. Institutions (e.g., what types of institutional arrangements perpetuate tobacco supply, what types of institutional arrangements have fostered alternatives to tobacco production and how);
  3. Ideas (e.g., what types of ideas are dominant across health and economic sectors and to what effect, where do these ideas converge or diverge, how are these ideas mobilized, what types of ideas are implicit or explicit in institutions, how have ideas changed over time).

Dr. Raphael Lencucha
Dr. Jeffrey Drope
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All papers will be peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2300 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • tobacco control policies
  • institutions
  • ideas
  • policy process
  • tobacco interests
  • global health
  • political economy
  • tobacco farming
  • tobacco supply
  • low- and middle-income countries

Published Papers (11 papers)

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Research

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Article
An Overview of the Policy and Market Landscape of Tobacco Production and Control in Mozambique
Int. J. Environ. Res. Public Health 2021, 18(1), 343; https://doi.org/10.3390/ijerph18010343 - 05 Jan 2021
Viewed by 1447
Abstract
Background: Tobacco growing has been considered a mainstay of Mozambique’s economy, but there is a dearth of analysis of the tobacco policy landscape in the country. Methods: Review of government and non-government documents and academic papers addressing Mozambique’s tobacco-growing history, the changes in [...] Read more.
Background: Tobacco growing has been considered a mainstay of Mozambique’s economy, but there is a dearth of analysis of the tobacco policy landscape in the country. Methods: Review of government and non-government documents and academic papers addressing Mozambique’s tobacco-growing history, the changes in the political economy of tobacco, and health policies addressing tobacco use and prevention of noncommunicable diseases. Results: Despite its tobacco growing and exporting history, the contribution of tobacco to the economy has been in steady decline in the past two decades, including in the areas dedicated to growing. At the same time there has been an increase in multinational control of the tobacco economy. In parallel, Mozambique’s commitment to addressing the growing burden of noncommunicable disease and accession to the Framework Convention on Tobacco Control indicate a potential for internal government tensions to balance immediate economic interests with long term health goals. Conclusions: With the decline in tobacco share of the overall economy, Mozambique may be well-positioned to explore alternative, sustainable livelihoods for farmers that grow tobacco, but it must overcome inter-sectoral barriers and advocate for a whole of government approach to address the health and economic impact of tobacco. Full article
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Article
The Economic Cost of Tobacco Farming in Bangladesh
Int. J. Environ. Res. Public Health 2020, 17(24), 9447; https://doi.org/10.3390/ijerph17249447 - 17 Dec 2020
Cited by 2 | Viewed by 886
Abstract
The extent of tobacco cultivation remains substantially high in Bangladesh, which is the 12th largest tobacco producer in the world. Using data from a household survey of current, former, and never tobacco farmers, based on a multi-stage stratified sampling design with a mix [...] Read more.
The extent of tobacco cultivation remains substantially high in Bangladesh, which is the 12th largest tobacco producer in the world. Using data from a household survey of current, former, and never tobacco farmers, based on a multi-stage stratified sampling design with a mix of purposive and random sampling of households, this study estimated the financial and economic profitability per acre of land used for tobacco cultivation. The environmental effects of tobacco cultivation on land and water resources were estimated using laboratory tests of sample water and soil collected from tobacco-cultivating and non-tobacco cultivating areas. The study finds that tobacco cultivation turns into a losing concern when the opportunity costs of unpaid family labour and other owned resources, and the health effects of tobacco cultivation are included. Tobacco cultivation poses a significantly high environmental cost that causes a net loss to society. Nevertheless, the availability of unpaid family labour and the options of advanced credit as well as a buy back guarantee from the tobacco companies attract farmers to engage in and continue tobacco cultivation. Therefore, supply side interventions to curb the tobacco epidemic in Bangladesh need to address major drivers of tobacco cultivation to correct the wrong incentives and motivate tobacco farmers to switch to alternative livelihood options. Full article
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Article
In-and-Out of Tobacco Farming: Shifting Behavior of Tobacco Farmers in Indonesia
Int. J. Environ. Res. Public Health 2020, 17(24), 9416; https://doi.org/10.3390/ijerph17249416 - 15 Dec 2020
Cited by 1 | Viewed by 953
Abstract
Understanding the variables that affect farmers’ decisions as to whether to grow tobacco and/or other crops provides important insights into their economic lives and can help to inform the development and implementation of policies that shape both tobacco production and tobacco control, such [...] Read more.
Understanding the variables that affect farmers’ decisions as to whether to grow tobacco and/or other crops provides important insights into their economic lives and can help to inform the development and implementation of policies that shape both tobacco production and tobacco control, such as increasing tobacco excise taxes. This study employs complementary quantitative and qualitative methodologies to identify variables that affect tobacco farmers’ economic decision making in Indonesia, a major tobacco producer. The research focuses on the variables that affect tobacco farmers’ decisions to continue tobacco farming or shift to non-tobacco farming. It finds that tobacco farmers’ decision making is complex but also predictable. The results of the quantitative analysis suggest that farming profits and positive rainfall shocks are two of the key variables that affect the decision to cultivate tobacco. The qualitative results confirm these findings and further illuminate that access to credit, education (agricultural and otherwise) and information play substantial roles in farmers’ economic decision making. Most of these variables are affected by the unequal relationship between the tobacco firms that buy tobacco and the farmers, wherein the farmers are consistently at a disadvantage in terms of negotiating key parameters such as prices and evaluation of leaf quality. Full article
Article
UK Research Priorities for Electronic Cigarettes: A James Lind Alliance Priority Setting Partnership
Int. J. Environ. Res. Public Health 2020, 17(22), 8500; https://doi.org/10.3390/ijerph17228500 - 17 Nov 2020
Cited by 1 | Viewed by 692
Abstract
This study aimed to bring together people who smoke or vape, people who do not smoke and healthcare professionals to identify and agree priorities for electronic cigarette research in the UK. We carried out a priority setting partnership, guided by the methodology developed [...] Read more.
This study aimed to bring together people who smoke or vape, people who do not smoke and healthcare professionals to identify and agree priorities for electronic cigarette research in the UK. We carried out a priority setting partnership, guided by the methodology developed by the James Lind Alliance involving five key stages: initiation, consultation, collation, prioritisation and dissemination. A total of 765 people submitted 1887 questions that they wanted answered by research. Questions were organised into themes, merged and rewritten as summary questions, with 52 unique questions going forward to the prioritisation survey. Participants then ranked their top 10 questions. Following this ranking exercise, the top 26 were identified by selecting the most frequently prioritised questions adjusting for representative stakeholder group. These were put forward for discussion in the final prioritisation workshop, whereby the top 10 electronic cigarette research questions were agreed. The list of priorities identified will be of interest to researchers and funders of electronic cigarette research and will hopefully direct future research and funding calls. These priorities provide insight into the questions that matter to people who are using or concerned about e-cigarettes, including frontline professionals. Full article
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Article
Online Simulation Model to Estimate the Total Costs of Tobacco Product Waste in Large U.S. Cities
Int. J. Environ. Res. Public Health 2020, 17(13), 4705; https://doi.org/10.3390/ijerph17134705 - 30 Jun 2020
Cited by 1 | Viewed by 2254
Abstract
Tobacco product waste (TPW) is one of the most ubiquitous forms of litter, accumulating in large amounts on streets, highways, sidewalks, beaches, parks, and other public places, and flowing into storm water drains, waste treatment plants, and solid waste collection facilities. In this [...] Read more.
Tobacco product waste (TPW) is one of the most ubiquitous forms of litter, accumulating in large amounts on streets, highways, sidewalks, beaches, parks, and other public places, and flowing into storm water drains, waste treatment plants, and solid waste collection facilities. In this paper, we evaluate the direct and indirect costs associated with TPW in the 30 largest U.S. cities. We first developed a conceptual framework for the analysis of direct and indirect costs of TPW abatement. Next, we applied a simulation model to estimate the total costs of TPW in major U.S. cities. This model includes data on city population, smoking prevalence rates, and per capita litter mitigation costs. Total annual TPW-attributable mean costs for large US cities range from US$4.7 million to US$90 million per year. Costs are generally proportional to population size, but there are exceptions in cities that have lower smoking prevalence rates. The annual mean per capita TPW cost for the 30 cities was US$6.46, and the total TPW cost for all 30 cities combined was US$264.5 million per year. These estimates for the TPW-attributable cost are an important data point in understanding the negative economic externalities created by cigarette smoking and resultant TPW cleanup costs. This model provides a useful tool for states, cities, and other jurisdictions with which to evaluate a new economic cost outcome of smoking and to develop new laws and regulations to reduce this burden. Full article
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Article
Factors Associated with Cultivation of Tobacco in Bangladesh: A Multilevel Modelling Approach
Int. J. Environ. Res. Public Health 2020, 17(12), 4277; https://doi.org/10.3390/ijerph17124277 - 15 Jun 2020
Cited by 2 | Viewed by 1052
Abstract
An increasing number of studies provide evidence on the serious negative consequences of tobacco farming on economic livelihoods, human health and the environment. There is, however, only limited research on tobacco farming in Bangladesh, a significant producer of tobacco leaf. It is not [...] Read more.
An increasing number of studies provide evidence on the serious negative consequences of tobacco farming on economic livelihoods, human health and the environment. There is, however, only limited research on tobacco farming in Bangladesh, a significant producer of tobacco leaf. It is not yet well understood why many farmers choose to grow tobacco considering the challenging context. Accordingly, this study examines the factors that influence farmers’ decisions to grow tobacco in Bangladesh. Socio-demographic and economic information was collected from 220 tobacco farmers and 117 non-tobacco farmers from the major tobacco-growing district of Kushtia, for a total sample of 337. These farmers were recruited from two sub-districts (or upazilla—Daulatpur and Mirpur) using a stratified random sampling. A two-level logistic regression model was applied for the identification of the variables that condition farmers’ decisions to cultivate tobacco leaf. Almost two-thirds of the sampled farmers (65.3%) chose to farm tobacco. The results demonstrate that the following variables shape most farmers’ decisions to cultivate tobacco: older age, less education, tobacco firms’ short-term financial support of growing tobacco, greater ease of selling tobacco products at market, better access to credit (also provided by the tobacco companies), and farmer’s perception about higher profits from tobacco cultivation compared to other crops. This study strongly suggests that the government and others working on tobacco control should consider engaging in initiatives to increase farmers’ education, perhaps particularly for older farmers, and provide meaningful financial support in part by helping to increase access to credit and ensuring a better market facility to sell their other healthier agricultural crops, goods and services. Full article
Article
Understanding Alternatives to Tobacco Production in Kenya: A Qualitative Analysis at the Sub-National Level
Int. J. Environ. Res. Public Health 2020, 17(6), 2033; https://doi.org/10.3390/ijerph17062033 - 19 Mar 2020
Cited by 3 | Viewed by 1184
Abstract
Tobacco is a key cash crop for many farmers in Kenya, although there is a variety of challenges associated with tobacco production. This study seeks to understand alternatives to tobacco production from the perspective of government officials, extension officers, and farmers at the [...] Read more.
Tobacco is a key cash crop for many farmers in Kenya, although there is a variety of challenges associated with tobacco production. This study seeks to understand alternatives to tobacco production from the perspective of government officials, extension officers, and farmers at the sub-national level (Migori, Busia, and Meru) in Kenya. The study analyzes data from qualitative key-informant interviews with government officials and extension officers (n = 9) and focus group discussions (FGDs) with farmers (n = 5). Data were coded according to pre-identified categories derived from the research aim, namely, opportunities and challenges of tobacco farming and alternative crops, as well findings that illustrate the policy environment that shapes the agricultural context in these regions. We highlight important factors associated with the production of non-tobacco agricultural commodities, including the factors that shape the ability of these non-agricultural commodities to serve as viable alternatives to tobacco. The results highlight the effect that several factors, including access to capital, markets, and governmental assistance, have on farmer decisions. The results additionally display the structured policy approaches that are being promoted in governmental offices towards agricultural production, as well as the institutional shortcomings that inhibit their implementation at the sub-national level. Full article
Article
“All Weather Friends”: How China Transformed Zimbabwe’s Tobacco Sector
Int. J. Environ. Res. Public Health 2020, 17(3), 723; https://doi.org/10.3390/ijerph17030723 - 22 Jan 2020
Cited by 4 | Viewed by 1718
Abstract
Recent research documents the globalization strategy of the Chinese tobacco industry since the early 2000s and risks posed to global health. There are limited analyses to date of how this strategy is playing out in specific countries. This paper analyses the expansion of [...] Read more.
Recent research documents the globalization strategy of the Chinese tobacco industry since the early 2000s and risks posed to global health. There are limited analyses to date of how this strategy is playing out in specific countries. This paper analyses the expansion of the China National Tobacco Company (CNTC) in Zimbabwe, the largest producer of tobacco leaf globally, since the early 2000s, through document analysis. It applies a political economy framework—identifying material, ideational and institutional forces—to demonstrate how CNTC capitalized on the unique features of China-Africa development cooperation to pursue its expansion goals, which threaten global public health efforts to reduce tobacco supply. In a context of economic crisis, CNTC offered substantial resources to revive Zimbabwe’s tobacco industry, promoting a shift to contract farming of its preferred leaf. It benefited from perceptions of state friendship, which it fostered through corporate social responsibility initiatives. Through ties with the Chinese embassy and economic actors, CNTC embedded its interests in development institutions. While contributing to improved foreign exchange earnings and some farmers’ livelihoods, CNTC’s expansion has increased the dependence on China as a development partner and tobacco as a crop, benefitting its “go global” strategy, while contributing to public health and environmental challenges locally and globally. The expansion of the Chinese tobacco industry interests in Zimbabwe offers lessons for global tobacco control and efforts to support alternatives to tobacco growing. Full article

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Protocol
Estimating the Magnitude of Illicit Cigarette Trade in Bangladesh: Protocol for a Mixed-Methods Study
Int. J. Environ. Res. Public Health 2020, 17(13), 4791; https://doi.org/10.3390/ijerph17134791 - 03 Jul 2020
Viewed by 1477
Abstract
The illicit tobacco trade undermines the effectiveness of tobacco tax policies; increases the availability of cheap cigarettes, which, in turn, increases tobacco use and tobacco related deaths; and causes huge revenue losses to governments. There is limited evidence on the extent of illicit [...] Read more.
The illicit tobacco trade undermines the effectiveness of tobacco tax policies; increases the availability of cheap cigarettes, which, in turn, increases tobacco use and tobacco related deaths; and causes huge revenue losses to governments. There is limited evidence on the extent of illicit tobacco trade particularly cigarettes in Bangladesh. The paper presents the protocol for a mixed-methods study to estimate the extent of illicit cigarette trade in Bangladesh. The study will address three research questions: (a) What proportion of cigarettes sold as retail are illicit? (b) What are the common types of tax avoidance and tax evasion? (c) Can pack examination from the trash recycle market be considered as a new method to assess illicit trade in comparison to that from retailers and streets? Following an observational research method, data will be collected utilizing empty cigarette packs from three sources: (a) retailers; (b) streets; and (c) trash recycle market. In addition, a structured questionnaire will be used to collect information from retailers selling cigarettes. We will select post codes as Primary Sampling Unit (PSU) using a multi-stage random sampling technique. We will randomly select eight districts from eight divisions stratified by those with land border and non-land border; and within each district, we will randomly select ten postcodes, stratified by rural (five) and urban (five) PSU to ensure maximum geographical variation, leading to a total of eighty post codes from eight districts. The analysis will report the proportions of packs that do not comply with the study definition of illicit. Independent estimates of illicit tobacco are rare in low- and middle-income countries such as Bangladesh. Findings will inform efforts by revenue authorities and others to address the effects of illicit trade and counter tobacco industry claims. Full article
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Protocol
The Political Economy of Tobacco in Mozambique and Zimbabwe: A Triangulation Mixed Methods Protocol
Int. J. Environ. Res. Public Health 2020, 17(12), 4262; https://doi.org/10.3390/ijerph17124262 - 15 Jun 2020
Cited by 1 | Viewed by 1187
Abstract
Changing global markets have generated a dramatic shift in tobacco consumption from high-income countries (HICs) to low- and middle-income countries (LMICs); by 2030, more than 80% of the disease burden from tobacco use will fall on LMICs. Propelling this shift, opponents of tobacco [...] Read more.
Changing global markets have generated a dramatic shift in tobacco consumption from high-income countries (HICs) to low- and middle-income countries (LMICs); by 2030, more than 80% of the disease burden from tobacco use will fall on LMICs. Propelling this shift, opponents of tobacco control have successfully asserted that tobacco is essential to the economic livelihoods of smallholder tobacco farmers and the economy of tobacco-growing countries. This nexus of economic, agricultural and public health policymaking is one of the greatest challenges facing tobacco control efforts, especially in LMICs. To date, there is a lack of comparative, individual level evidence about the actual livelihoods of tobacco-growing farmers and the political economic context driving tobacco production. This comparative evidence is critically important to identify similarities and differences across contexts and to provide local evidence to inform policies and institutional engagement. Our proposed four-year project will examine the economic situation of smallholder farmers in two major tobacco-growing LMICs—Mozambique and Zimbabwe—and the political economy shaping farmers’ livelihoods and tobacco control efforts. We will collect and analyze the existing data and policy literature on the political economy of tobacco in these two countries. We will also implement household-level economic surveys of nationally representative samples of farmers. The surveys will be complimented with focus group discussions with farmers across the major tobacco-growing regions. Finally, we will interview key informants in these countries in order to illuminate the policy context in which tobacco production is perpetuated. The team will develop country-level reports and policy briefs that will inform two sets of dissemination workshops in each country with relevant stakeholders. We will also conduct workshops to present our findings to the survey and focus group participants, and other members of these tobacco-growing communities, so they can directly benefit from the research to which they are contributing. Full article
Brief Report
Legal Steps to Secure the Tobacco Supply Chain: A Case Study of Poland
Int. J. Environ. Res. Public Health 2020, 17(6), 2055; https://doi.org/10.3390/ijerph17062055 - 20 Mar 2020
Viewed by 974
Abstract
The threat of tobacco tax evasion and avoidance is the most commonly mentioned argument against tax hikes. Increasingly, the focus of legislators is on leaks in the tobacco crop supply chain, in which raw or cured tobacco that was never taxed finds its [...] Read more.
The threat of tobacco tax evasion and avoidance is the most commonly mentioned argument against tax hikes. Increasingly, the focus of legislators is on leaks in the tobacco crop supply chain, in which raw or cured tobacco that was never taxed finds its way to smokers. To study the process undertaken by Poland to secure the tobacco supply chain, we analyzed the 2013–2018 legislation around tobacco supply and interviewed a key stakeholder in the Government of Poland. We found that farmers and intermediary entities can trade tobacco only if registered with the government. Farmers are required to report the size of their fields and the weight of their crops to the state authorities. Each purchase within the supply chain is also reported by both the seller and the buyer for cross-validation. This has prevented manipulation within the system, while the mere threat of heavy fines related to an excise tax law violation and/or the administrative burden associated with becoming an excise tax payer (had the violation been prosecuted) has significantly contributed to securing the tobacco supply chain. The experience of Poland demonstrates that securing the tobacco supply chain is complicated but also a tractable problem. This case can be widely applicable to other countries. Full article
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