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Tobacco control legislation: an introductory guide
  1. S F Gambescia

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    Edited by D D Blanke. Geneva: World Health Organization, 2003, pp 261. ISBN 92-4-159066-1

    Beginner’s guide to tobacco control legislation

    Tobacco control legislation is one World Health Organization tool developed in response to the historic Framework Convention on Tobacco Control (FCTC). Recognising that legislation is critical to meaningful progress in tobacco control and that member states are at various stages of a comprehensive approach, this work serves as an introductory guide for those charged with establishing mandates to control the spread of tobacco use.

    The guide assumes the users—health officials, advocates, lawyers, leaders within non-governmental organisations—have little legislative and policymaking experience. Generally, the book takes a macro level approach in coaching users to introduce and implement meaningful tobacco control policies at the national or sub-national levels. It does not attempt to answer all questions related to the formidable task of passing tobacco control laws, but identifies the sundry of questions that need to be asked to facilitate success in effecting change in these areas. For example, the guide reinforces the need to create a broad based coalition to support a legislative effort, but does not attempt to answer how to form or manage a coalition.

    The guide designs a framework to assist in implementing the FCTC, so to speak. After an initial summary chapter—written in six languages—an introduction, a rationale for a legislative strategy, and a chapter on terms and concepts in the legislative process, the bulk of the guide addresses the major action steps needed to establish progressive legislation. These include:

    • capacity building for success

    • identifying strategic legislative approaches

    • choosing elements of a comprehensive plan

    • drafting the legislation

    • identifying and responding to the opposition and obstacles

    • fighting the legislative battle

    • implementing the laws

    • evaluating the laws.

    The remainder of the book covers case studies from nine countries—offering some lessons learned—an introduction to the purpose and meaning of international laws, and a brief concluding chapter.

    The guide is cogently written, so as to not overwhelm the intended users. This should keep the readers interested and facilitate off-the-shelf utilisation of material. However, the contributors provide enough strategic commentary to alert the reader that when lobbying for tobacco control laws, it will take a lot of information gathering, skill, passion, patience, and perseverance.

    The central chapter of the book, on the essential elements of a comprehensive legislative plan—from product regulation to risk awareness to sales—is presented with much confidence because the contributors believe, “We know what works” (p 46). The guide presents not only a rationale and strategy for passing legislation but identifies the likely obstacles and barriers set by the opposition, directly or indirectly aligned with the tobacco industry.

    The contributors are acutely aware that the “Legislative process is dynamic and unpredictable” (p 129); therefore, advocates for tobacco control policies need to be flexible and open to effective compromise. However, the book’s major purpose and contribution is to have tobacco control advocates design a plan to balance the passion in improving the health status of its citizens.

    Naturally the authors see the gathering of credible information as a keystone to any tobacco control policy implementation plan. The guide notes, “In policy-making, evidence [health burden, economic impact, political mapping, public opinion, and tobacco exposes] is power!” (p 83). While tobacco control advocates may not have the pressure and influence to bear on legislators, as does the ferocious multinational tobacco companies, there is faith that well researched and credible information presented to legislators in a professional manner will eventually gain favour.

    Material in at least two chapters should be new, for the experienced tobacco control advocate. The chapter on drafting legislation encourages collaboration with those who have this technical expertise—without sacrificing the fundamental purpose at hand. This is one step, the authors warn, that you should not go alone. A chapter at the end of the book gives a briefing on the nature and significance of international treaties and laws related to the current environment of tobacco control.

    There are two brief annexes and a selected readings section at the end. One annex is a template for a comprehensive “Tobacco Products Control Act”, and the other is a list of a score of websites from countries that have had successful model legislation.

    While the passage of laws, at all governmental levels, to regulate the spread of tobacco has never been so promising, the contributors advise throughout this guide that the trick to real progress comes with a shift in the culture of society: “…in the final analysis, it is the norms and values of a society that determine whether tobacco use is accepted” (p 85). Those who complete this guide will become even more valuable to the tobacco control movement in their states if they continue their studies in this direction.