Abstract
The MPOWER policy package enables countries to implement effective, evidence-based strategies to address the threat posed to their population by tobacco. All countries have challenges to overcome when implementing tobacco control policy. Some are generic such as tobacco industry efforts to undermine and circumvent legislation; others are specific to national or local context. Various factors influence how successfully challenges are addressed, including the legal-political framework for enforcement, public and administrative attitudes towards the law, and whether policy implementation measures are undertaken. This paper examines District Tobacco Control Taskforces, a flexible policy mechanism developed in Bangladesh to support the implementation of the Smoking and Tobacco Products Usage (Control) Act 2005 and its 2013 Amendment. At the time of this study published research and/or data was not available and understanding about these structures, their role, contribution, limitations and potential, was limited. We consider Taskforce characteristics and suggest that the “package” comprises a distinctive tobacco control implementation model. Qualitative data is presented from interviews with key informants in ten districts with activated taskforces (n = 70) to provide insight from the perspectives of taskforce members and non-members. In all ten districts taskforces were seen as a crucial tool for tobacco control implementation. Where taskforces were perceived to be functioning well, current positive impacts were perceived, including reduced smoking in public places and tobacco advertising, and increased public awareness and political profile. In districts with less well established taskforces, interviewees believed in their taskforce’s ‘potential’ to deliver similar benefits once their functioning was improved. Recommendations to improve functioning and enhance impact were made. The distinctive taskforce concept and lessons from their development may provide other countries with a flexible local implementation model for tobacco control.
Highlights
The tobacco epidemic is having devastating impacts across the globe, with low- and middle-income countries (LMICs) facing a disproportionate burden
We focus on local-level tobacco control taskforces, a particular approach to assist tobacco control implementation in Bangladesh
Taskforces were universally perceived to be a crucial tool for tobacco control in Bangladesh
Summary
The tobacco epidemic is having devastating impacts across the globe, with low- and middle-income countries (LMICs) facing a disproportionate burden. Of all tobacco-attributed deaths occur in LMICs [2]. Many of these countries are faced with rising affordability of tobacco products [3] and an aggressive tobacco industry that targets consumers and governments [4]. To combat the tobacco epidemic and its health and economic burdens, the World. Health Organization (WHO) in 2008 introduced a package of six evidence-based measures, collectively known as “MPOWER”, to assist all countries to implement effective tobacco control. Implementation of the highest-level ‘MPOWER’ policies adopted between 2007 to 2010 is predicted to avert nearly
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