An analysis of policies to control tobacco use and alcohol consumption as risk factors of noncommunicable diseases: A case study of Iran

Abstract

AbstractControl of noncommunicable diseases (NCDs) requires the management of behavioral risk factors such as tobacco smoking and alcohol consumption. Alcohol consumption and tobacco use are the main risk factors of NCDs and account for about 1% and 13% of total deaths in Iran, respectively. This study aimed to analyze policies regarding tobacco use and alcohol consumption and understand their content, context, process, and actors in Iran. We conducted a case study design guided by the Walt and Gilson Policy Analysis Framework. This study was conducted in two phases: A review of policy documents on tobacco and alcohol, and scoping review of studies related to the policies identified in the first phase. The contents of tobacco and alcohol control policies are mostly in line with international recommendations including, the MPOWER policy package for tobacco and recommended target areas proposed by World Health Organization (WHO) for alcohol. Political commitment to health promotion, social and religious values, joining international treaties, and the high prevalence of NCDs have been significant factors in the agenda‐setting of alcohol and tobacco policies in Iran. Although the health governance structure and the primary health care system have provided opportunities for implementation of policies, weak cross‐sectoral collaboration and the lack of some stakeholders' support, including the tobacco industry, pose challenges to the successful implementation of tobacco and alcohol policies. Thus, a multi‐sectoral approach is essential to control NCDs in Iran.