Abstract
Introduction:Coalitions of supporters of comprehensive tobacco control policy have been crucial in achieving policy success nationally and internationally, but the dynamics of such alliances are not well understood.Methods:Qualitative semi-structured, narrative interviews with 35 stakeholders involved in developing the European Council Recommendation on smoke-free environments. These were thematically analyzed to examine the dynamics of coalition-building, collaboration and leadership in the alliance of organizations which successfully called for the development of comprehensive European Union (EU) smoke-free policy.Results:An alliance of tobacco control and public health advocacy organizations, scientific institutions, professional bodies, pharmaceutical companies, and other actors shared the goal of fighting the harms caused by second-hand smoke. Alliance members jointly called for comprehensive EU smoke-free policy and the protection of the political debates from tobacco industry interference. The alliance’s success was enabled by a core group of national and European actors with long-standing experience in tobacco control, who facilitated consensus-building, mobilized allies and synchronized the actions of policy supporters. Representatives of Brussels-based organizations emerged as crucial strategic leaders.Conclusions:The insights gained and identification of key enablers of successful tobacco control advocacy highlight the strategic importance of investing into tobacco control at European level. Those interested in effective health policy can apply lessons learned from EU smoke-free policy to build effective alliances in tobacco control and other areas of public health.
Highlights
Coalitions of supporters of comprehensive tobacco control policy have been crucial in achieving policy success nationally and internationally, but the dynamics of such alliances are not well understood
This study focuses on the European Council Recommendation on smoke-free environments, a nonbinding document recommending that member states adopt and implement policies to effectively protect their citizens from exposure to second-hand smoke (SHS).[17]
Members of the smoke-free alliance jointly promoted the following three key messages in the policy debates: (a) population health should be improved by protecting European Union (EU) citizens from the harms caused by SHS; (b) comprehensive smoke-free policies without exemptions are the only way to achieve effective protection from SHS; and (c) given that tobacco companies are the main vector of the tobacco epidemic, tobacco industry representatives should have no opportunity to influence the process of developing smoke-free policies
Summary
Coalitions of supporters of comprehensive tobacco control policy have been crucial in achieving policy success nationally and internationally, but the dynamics of such alliances are not well understood. Conclusions: The insights gained and identification of key enablers of successful tobacco control advocacy highlight the strategic importance of investing into tobacco control at European level Those interested in effective health policy can apply lessons learned from EU smoke-free policy to build effective alliances in tobacco control and other areas of public health. Of comprehensive European Union (EU) smoke-free policy as a recent example of successful EU tobacco control policy, this article is the first to empirically analyze a tobacco control alliance in EU policymaking. For example, argues that a strong urge to combine forces amid a common or immediate threat means that issues of high salience and controversy are likely to generate coalition-building,[16] while Keck and Sikkink emphasize advocates’ characteristics and relationships as determining the performance and success of coalitions.[12]
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