Tobacco Control Policy in Scotland: A Qualitative Study of Expert Views on Successes, Challenges and Future Actions.

Yvonne Laird,John Mcateer,Garth Reid,Fiona Myers

doi:10.3390/ijerph16152659

Abstract

The Scottish Government launched a tobacco control strategy in 2013 with the ambition of making Scotland tobacco smoke-free by 2034. However, 17% of the adult population in Scotland smoke cigarettes. This study aimed to provide insight into why policies are successful or not and provide suggestions for future policy actions. Individual interviews with ten tobacco control experts were conducted and the results were analyzed using thematic analysis. Key successes included strong political leadership, mass media campaigns, legislation to address availability and marketing of cigarettes and tobacco products, and legislation to reduce second-hand smoke exposure. Challenges included implementing policy actions, monitoring and evaluation of tobacco control actions, addressing health inequalities in smoking prevalence, and external factors that influenced the success of policy actions. Key suggestions put forward for future policy actions included addressing the price and availability of tobacco products, maintaining strong political leadership on tobacco control, building on the success of the ‘Take it Right Outside’ mass media campaign with further mass media campaigns to tackle other aspects of tobacco control, and developing and testing methods of addressing inequalities in cigarette smoking prevalence. The findings of this study can inform future tobacco control policy in Scotland and have relevance for tobacco control policies in other countries.

Highlights

The well-established harmful effects of cigarette smoking have led to global action to reduce tobacco smoking prevalence [1], including the introduction of a number of tobacco control policies by governments across the world
Several participants felt that the bold targets and policies introduced by the Scottish Government, such as being the first nation to introduce a target for a smoke-free generation, have led to strong international exposure and have placed Scotland as a leader internationally for tobacco control
This study provides a rich qualitative account of tobacco control policy in Scotland between 2013 and 2018, experts’ views on the successes and challenges of these policy actions, and suggestions for future policy actions

Summary

Introduction

The well-established harmful effects of cigarette smoking have led to global action to reduce tobacco smoking prevalence [1], including the introduction of a number of tobacco control policies by governments across the world. In 2013, the Scottish Government launched a national tobacco control strategy with the aim of making Scotland tobacco smoke-free by 2034 [2]. Between 2013 and 2016, tobacco smoking prevalence remained relatively static, with an approximate prevalence of 21% of the adult population in Scotland who smoked cigarettes. The most recent prevalence data suggests tobacco smoking has declined, with 17% of the adult population in Scotland who smoke cigarettes [3]. Prevalence of tobacco smoking is high for those in the most deprived areas, where 30% of adults smoke compared with 10% in the least deprived communities in Scotland. In order to achieve the Scottish Government’s ambition of making Scotland

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