Background Nepal was a monarchy, then a dictatorship, then a democracy. This paper reviews how tobacco control progressed in Nepal in the context of these changes in government from 1950 through 2006.
Methods We triangulated tobacco industry documents, newspaper articles and key informant interviews.
Results Until 1983, the tobacco industry was mostly state owned. Transnational tobacco companies entered the Nepalese market through ventures with Surya Tobacco Company Private Limited (with Imperial Tobacco Company and British American Tobacco) in 1983 and Seti Cigarette Factory Limited (with Philip Morris International [PMI]) in 1985. Seminars and conferences on tobacco, celebrations of World No Tobacco Day (WNTD) and efforts by WHO helped promote tobacco control in Nepal beginning in the 1970s. Tobacco advocates in Nepal pushed the government to issue executive orders banning smoking in public places in 1992 and tobacco advertising in electronic media in 1998, and to introduce a tobacco health tax in 1993. The tobacco industry lobbied against these measures and succeeded in keeping the tobacco tax low by challenging it in court. Tobacco advocates sued the government in 2003 and 2005, resulting in a June 2006 Supreme Court decision upholding the smoking and advertising bans and requiring the government to enact a comprehensive tobacco control law.
Conclusions Political instability, conflict, weak governance and the dictatorship significantly affect tobacco control activities in low-income and middle-income countries. Nepal shows that tobacco control advocates can take advantage of global events, such as WNTD, and use domestic litigation to maintain support from civil societies and to advocate for stronger tobacco control policies.
- low/middle income country
- tobacco industry
- tobacco industry documents
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Contributors DB developed the idea for this study, carried out the data collection and analysis, wrote and revised the manuscript. SG developed the idea for this study, revised and edited the manuscript. SB and EC revised and edited the manuscript.
Funding This research was funded by National Cancer Institute grant CA-087472. The funding agency played no role in the conduct of the research or preparation of the manuscript.
Competing interests None declared.
Patient consent for publication Not required.
Ethics approval This study was approved by UCSF Committee on Human Research.
Provenance and peer review Not commissioned; externally peer reviewed.
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