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Tobacco industry access to policy elites and the implementation of Article 5.3 of the WHO Framework Convention on Tobacco Control
  1. Marc C Willemsen1,2,
  2. Gary Fooks3
  1. 1Health Promotion, Maastricht University CAPHRI School for Public Health and Primary Care, Maastricht, The Netherlands
  2. 2Tobacco Control, Trimbos-instituut, Utrecht, The Netherlands
  3. 3School for Languages and Social Science, Aston University, Birmingham, UK
  1. Correspondence to Professor Marc C Willemsen, Health Promotion, Maastricht University CAPHRI School for Public Health and Primary Care, Maastricht 6200MD, Netherlands; marc.willemsen{at}


Introduction Article 5.3 WHO Framework Convention on Tobacco Control (FCTC) aims to prevent tobacco industry interference with public health policy. The degree of protection depends on several factors: the interpretation of Article 5.3 by governments; the presence of codes of practice; and the effectiveness of industry lobbying versus public health advocacy. We examine these factors with reference to the Dutch government’s interpretation of Article 5.3.

Methods We searched the Dutch Tobacco Industry Special Collection, part of the Truth Tobacco Industry Documents archive, containing more than 1100 Dutch government documents.

Results Between 2007 and 2012, under consistent pressure from the industry, an initial strict view of Article 5.3 gave way to increased contact with the industry. The industry tried to shift the governance of tobacco policy back to the Ministry of Economic Affairs. Around 2010, Dutch public health advocates began to use Article 5.3. Efforts included naming and shaming government contact with the industry, parliamentary questions about industry–government contact, a report outlining how Article 5.3 should be observed and, most importantly, a court case. In response to this, the government produced a formal code of practice, which was used to prevent industry involvement in the development of a new National Prevention Accord.

Discussion The Dutch government’s initial decision not to codify Article 5.3 created an administrative environment in which health ministers’ interpretation of Article 5.3 was able to shift according to their political beliefs. The findings support the recommendation that Parties to the FCTC take a strict approach and formally codify Article 5.3 to ensure effective implementation.

  • tobacco industry lobby
  • FCTC
  • Europe
  • public health policy
  • advocacy
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  • Contributors MCW conceived the paper and wrote the first draft. MCW and GF contributed with revisions and approved the final version of the paper.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

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

  • Data availability statement Data may be obtained from a third party and are not publicly available.

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