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Implementation of effective cigarette health warning labels among low and middle income countries: State capacity, path-dependency and tobacco industry activity

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  • Hiilamo, Heikki
  • Glantz, Stanton A.

Abstract

We investigates the effects of ratifying the WHO Framework Convention of Tobacco Control (FTCT), state capacity, path-dependency and tobacco industry activity on the implementation of effective health warning labels (HWL) on cigarette packs among low and middle income countries (LMIC). Using logistic regression in separate analyses for FCTC Article 11 compliant HWLs and graphic HWLs (GHWL), we found that the odds of FCTC compliance increased by a factor of 1.31 for each year after FCTC entered into force in the country (p < 0.01). The odds of passing GHWLs increased by a factor of 1.46 (p < 0.05) per year after FCTC entered into force. The weaker the capacity of the states were, the less likely they were to have implemented FCTC compliant HWLs (p < 0.05). The countries with voluntary HWLs in 1992 were less likely (OR = 0.19, p < 0.01) to comply with FCTC 21 years later (in 2013). The FCTC has promoted HWL policies among LMICs. Public health regulations require investments in broader state capacity. As the theory of path-dependency predicts voluntary agreements have long lasting influence on the direction of tobacco control in a country. Adopting voluntary HWL policies reduced likelihood of having FCTC compliant HWLs decades later. The fact that voluntary agreements delayed effective tobacco regulations suggests that policymakers must be careful of accepting industry efforts for voluntary agreements in other areas of public health as well, such as alcohol and junk food.

Suggested Citation

  • Hiilamo, Heikki & Glantz, Stanton A., 2015. "Implementation of effective cigarette health warning labels among low and middle income countries: State capacity, path-dependency and tobacco industry activity," Social Science & Medicine, Elsevier, vol. 124(C), pages 241-245.
  • Handle: RePEc:eee:socmed:v:124:y:2015:i:c:p:241-245
    DOI: 10.1016/j.socscimed.2014.11.054
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    References listed on IDEAS

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    Cited by:

    1. Christopher M. Seitz & Kenneth D. Ward & Zubair Kabir, 2021. "Quitline Information Included on Cigarette Packaging: An Assessment of Country Adherence to WHO FCTC Guidelines, 2007 to 2018," IJERPH, MDPI, vol. 18(22), pages 1-7, November.
    2. Valente, Thomas W. & Pitts, Stephanie & Wipfli, Heather & Vega Yon, George G., 2019. "Network influences on policy implementation: Evidence from a global health treaty," Social Science & Medicine, Elsevier, vol. 222(C), pages 188-197.
    3. Andrea Vaccaro, 2023. "Measures of state capacity: so similar, yet so different," Quality & Quantity: International Journal of Methodology, Springer, vol. 57(3), pages 2281-2302, June.

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