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Tobacco control: comparative politics in the United States and Canada
  1. C Callard
  1. Physicians for a Smoke-Free Canada;

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    By D T Studlar, Broadview Press, 2002, US$19.95, CDN$29.95, £14.99, ISBN: 1-55111-456-9.

    Tobacco control in the USA and Canada

    Although tobacco control is a multidisciplinary field, it is one that is practised by considerably fewer political scientists than health practitioners, lawyers or economists. For that reason alone, Donley Studlar’s examination of the development of tobacco control measures in the USA and Canada is a noteworthy contribution. There are many reasons other than novelty to read and reflect upon this political scientist’s analysis of how similar-but-different nations with similar-but-different constraints adopted similar-but-different public measures and achieved similar-but-different results.

    In analysing the flow of policies north and south across the border, this study provides useful explanations for why some ideas are more readily received than others. Professor Studlar thoughtfully presents major differences in US and Canadian political systems, cultures and institutions that impact on tobacco measures. These include contrasting constitutional principles (“peace, order and good government” in Canada and “life, liberty and the pursuit of happiness” in the USA), different political institutions (parliamentary versus congressional), differing electoral realities (American legislators are far more likely to be re-elected and far less beholden to the “party-line”), and differing forms of citizen engagement (Canadian history of “elite accommodation” versus public lobbying in the USA).

    Professor Studlar sets out not only to compare and contrast the political response to tobacco over the past century in these two countries, but to draw lessons from the varying experiences, to trace cross border influences, and to project future trends. Along the way, he provides ample narrative and statistical detail and a concise and useful history of tobacco measures in two countries, 10 provinces, and 50 states. He uses this historical detail not so much to tell the story of policymaking as to explore the theories that might explain it. How does tobacco get on the agenda? Who influences government? How do political institutions respond? What types of policy are adopted? How are policy ideas shared?

    Evidence base

    For the positivist advocate in search of better strategies, this book holds the promise of an evidence base from which better plans can be made. That promise is only somewhat fulfilled, as the reader comes away with a better idea of what transpired than why it happened. There is more information than insight, and not too much to guide policy makers in how to improve their political game. This is, perhaps, not so much a failure of this political scientist as the limitations of political science, even when written as gracefully and accessibly as this study.

    “History,” they say, “is written by the victors.” Tobacco control history, it would appear from this work, is written by the advocates. In preparing this book, Professor Studlar interviewed a few dozen individuals working in tobacco control, mostly in non-governmental organisations (NGOs) or government departments. Most policy advances, it would appear he was told, can be credited to the very people he was interviewing. Perhaps the contributions of less vested participants, say a journalist or senior public servant, and less reliance on first person accounts would have provided a more robust, and perhaps more insightful, explanation of how Canada and the USA have moved forward.

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    Finally, given the very different approaches taken in Canada and the USA on other public issues (universal medicare, gun control, alcohol regulation, death penalty, welfare, public utilities), it is somewhat surprising that Professor Studlar assesses tobacco regulation in the USA and Canada as being headed in the same direction, with “leap-frogging” of similar measures adopted from each other. He does not explore how the differences between nations might allow for very different policy destinations. Perhaps the US tobacco companies will be litigated into bankruptcy before the first major lawsuit winds its way slowly to trial in a less litigious Canada. Perhaps cigarettes will have been totally removed from regular retail outlets (and put into liquor stores) before cigarette advertising at retail level is outlawed in the less regulated USA.

    Hopefully, these and other ground-breaking initiatives will soon be the subject of an update to this helpful study.