Abstract

Shifting patterns of tobacco production and consumption, and the resultant disease burden worldwide since the late twentieth century, prompted efforts to strengthen global health governance through adoption of the Framework Convention on Tobacco Control. While the treaty is rightfully considered an important achievement, to address a neglected public health issue through collective action, evidence suggests that tobacco industry globalization continues apace. In this article, we provide a systematic review of the public health literature and reveal definitional and measurement imprecision, ahistorical timeframes, transnational tobacco companies and the state as the primary units and levels of analysis, and a strong emphasis on agency as opposed to structural power. Drawing on the study of globalization in international political economy and business studies, we identify opportunities to expand analysis along each of these dimensions. We conclude that this expanded and interdisciplinary research agenda provides the potential for fuller understanding of the dual and dynamic relationship between the tobacco industry and globalization. Deeper analysis of how the industry has adapted to globalization over time, as well as how the industry has influenced the nature and trajectory of globalization, is essential for building effective global governance responses. This article is published as part of a thematic collection dedicated to global governance.

Highlights

  • The marked shift in tobacco-related disease and death, from traditional to emerging markets in low and middle-income countries (LMICs), began to garner major attention within the public health community during the 1980s (Stebbins, 1987)

  • The Framework Convention on Tobacco Control (FCTC) is rightfully lauded as a key marker in emerging forms of global health governance (GHG)

  • Data on tobacco consumption has been significantly improved through the four surveys of the Global Tobacco Surveillance System—Global Youth Tobacco Survey, Global School Personnel Survey, Global Health Professions Student Survey, and Global Adult Tobacco Survey—developed by the US Centers for Disease Control, World Health Organization (WHO) and Canadian Public Health Association

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Summary

Introduction

The marked shift in tobacco-related disease and death, from traditional to emerging markets in low and middle-income countries (LMICs), began to garner major attention within the public health community during the 1980s (Stebbins, 1987). We begin by reviewing the existing public health literature on tobacco industry globalization, identifying how globalization is defined and measured, historically located, conceptualised by unit and level of analysis, and ascribed with power.

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