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Role of stakeholders in Nigeria’s tobacco control journey after the FCTC: lessons for tobacco control advocacy in low-income and middle-income countries
  1. Catherine O Egbe1,2,
  2. Stella A Bialous1,3,
  3. Stanton Glantz1,4
  1. 1 Center for Tobacco Control Research and Education, University of California, San Francisco, California, USA
  2. 2 Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, Pretoria, South Africa
  3. 3 Social and Behavioral Sciences Department, School of Nursing, and Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, California, USA
  4. 4 Department of Medicine (Cardiology), Cardiovascular Research Institute, Philip R. Lee Institute for Health Policy Studies, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, California, USA
  1. Correspondence to Professor Stanton Glantz, Medicine/Cardiology, University of California San Francisco, San Francisco,California 94143-1390, USA; glantz{at}


Introduction Nigeria ratified the WHO Framework Convention on Tobacco Control (FCTC) in 2005. Tobacco control advocates in Nigeria achieved some success in countering tobacco industry interference to implement the FCTC.

Methods We triangulated interviews with key informants from local and international organisations who worked in Nigeria with documentation of the legislative process and Nigerian newspaper articles. Data were analysed and interpreted using the Policy Dystopia Model and WHO categories of tobacco industry interference that had been developed mostly based on experience in high-income countries.

Results As in high-income countries, the tobacco industry continued to oppose tobacco control policies after Nigeria ratified the FCTC, including weakening Nigeria’s 2015 National Tobacco Control Act. Both tobacco control advocates and industry used discursive (argument-based) and instrumental (activity-based) strategies. The industry argued self-regulation and the economic importance of tobacco. They exploited legislative procedures, used front groups and third parties to push for pro-industry changes. Advocates, with help from international organisations, mobilised prominent Nigerians and the public. Advocates pre-empted and countered the industry through traditional and social media, monitoring and exposing tobacco industry activities, and by actively engaging lawmakers and citizens during the legislative process.

Conclusion The Policy Dystopia Model and WHO categories of industry interference provide a helpful framework for understanding tobacco control debates in low/middle-income countries (LMICs) as in high-income countries. One difference in LMIC is the important role of international tobacco control advocates in supporting national tobacco control advocates. This partnership is important in pushing for FCTC-compliant legislation and countering industry activities in LMIC.

  • advocacy
  • global health
  • low/middle income country
  • public policy
  • tobacco industry

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  • Contributors COE collected the data and drafted the paper. SAB and SG supervised the work and revised the paper.

  • Funding This work was funded by National Cancer Institute Grant CA-087472.

  • Disclaimer The funding agency played no role in the conduct of the research or preparation of the manuscript.

  • Competing interests SAB has consulted with WHO and the FCTC Secretariat since the early negotiations of the FCTC. Other authors have nothing to declare.

  • Patient consent Not required.

  • Ethics approval All interviews were conducted in accordance with a protocol approved by the University of California San Francisco Committee on Human Research.

  • Provenance and peer review Not commissioned; externally peer reviewed.