Abstract
Changing global markets have generated a dramatic shift in tobacco consumption from high-income countries (HICs) to low- and middle-income countries (LMICs); by 2030, more than 80% of the disease burden from tobacco use will fall on LMICs. Propelling this shift, opponents of tobacco control have successfully asserted that tobacco is essential to the economic livelihoods of smallholder tobacco farmers and the economy of tobacco-growing countries. This nexus of economic, agricultural and public health policymaking is one of the greatest challenges facing tobacco control efforts, especially in LMICs. To date, there is a lack of comparative, individual level evidence about the actual livelihoods of tobacco-growing farmers and the political economic context driving tobacco production. This comparative evidence is critically important to identify similarities and differences across contexts and to provide local evidence to inform policies and institutional engagement. Our proposed four-year project will examine the economic situation of smallholder farmers in two major tobacco-growing LMICs—Mozambique and Zimbabwe—and the political economy shaping farmers’ livelihoods and tobacco control efforts. We will collect and analyze the existing data and policy literature on the political economy of tobacco in these two countries. We will also implement household-level economic surveys of nationally representative samples of farmers. The surveys will be complimented with focus group discussions with farmers across the major tobacco-growing regions. Finally, we will interview key informants in these countries in order to illuminate the policy context in which tobacco production is perpetuated. The team will develop country-level reports and policy briefs that will inform two sets of dissemination workshops in each country with relevant stakeholders. We will also conduct workshops to present our findings to the survey and focus group participants, and other members of these tobacco-growing communities, so they can directly benefit from the research to which they are contributing.
Highlights
Tobacco use remains the single most important cause of preventable morbidity and premature mortality worldwide
The livelihood argument for tobacco farming is routinely invoked by the tobacco industry and used to gain access to, and influence, policymakers in key economic ministries in many low- and middle-income countries (LMICs) [2,3,4]
We have found that the narrative that dominates in tobacco-growing countries is that tobacco production is an economic issue, and that it is primarily for export
Summary
Tobacco use remains the single most important cause of preventable morbidity and premature mortality worldwide. The rising consumption rates in tobacco-growing countries adds weight to the need to explore how governments navigate the tension between economic and health policy This project will expand ongoing research that investigates how the political economy of tobacco supply affects tobacco control efforts in SSA (Kenya, Zambia, and Malawi) and Indonesia, and empirically examines the economic livelihoods of smallholder farmers. We sought to explain how government institutions can shape this policy nexus [13], by incentivizing tobacco production [8], and how support for tobacco production has become institutionalized in tobacco-growing countries, such as the legislative protection of the tobacco industry in the Philippines [14] and the promotion of the industry in Zambia [8,15] This line of inquiry has generated important findings on the factors that contribute to policy incoherence with respect to international health commitments (such as the FCTC). The present studies include variables that allow for an analysis of factors associated with tobacco growing, including proximity to markets, perceptions of viability and profitability, and access to credit and inputs (e.g., seed and fertilizer) [30]
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