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Health promotion research and practice require sound policy analysis models: The case of Quebec's Tobacco Act

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  • Breton, Eric
  • Richard, Lucie
  • Gagnon, France
  • Jacques, Marie
  • Bergeron, Pierre

Abstract

In this paper we illustrate how policy analysis models can deepen our understanding of the challenges facing health promoters advocating for policy change. Specifically we describe the factors underpinning the adoption of Québec's Tobacco Act (1998) and the role played by actors from governmental public health agencies (GPHAs). Data were collected through interviews (n = 39), newspapers articles (n = 569) and documents (n > 200) from GPHAs, NGOs, the Québec National Assembly, and opponents to the legislative measures. Data collection and analysis were based on Sabatier and Jenkins-Smith's Advocacy Coalition Framework (1999) and Lemieux's theorization of coalition structuring (1998). We explain the adoption of the Act by: (1) the broad recognition within the policy elite of the main parameters of tobacco use (i.e. lethality, addictive properties, and legitimacy of governmental intervention), (2) the impacts of a series of events (e.g. cigarette contraband crisis) that enabled tobacco control advocates to influence public debates, and the governmental agenda, (3) the critical contribution of a coalition of GPHAs pooling resources to address both the sanitary and economic aspects of the legislation while countering the opposition's strategy, and (4) the failure of the opponents to present an unified voice on the definition of the tobacco policy. This study illustrates the merits of applying a policy-change model to grasp the complexity of the process. Our findings call for the development of permanent policy analysis capabilities within public health agencies and for a broader scrutiny of the non-health-related dimensions of policy debates.

Suggested Citation

  • Breton, Eric & Richard, Lucie & Gagnon, France & Jacques, Marie & Bergeron, Pierre, 2008. "Health promotion research and practice require sound policy analysis models: The case of Quebec's Tobacco Act," Social Science & Medicine, Elsevier, vol. 67(11), pages 1679-1689, December.
    • Handle: RePEc:eee:socmed:v:67:y:2008:i:11:p:1679-1689
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    References listed on IDEAS

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    1. Lewis, Jenny M., 2006. "Being around and knowing the players: Networks of influence in health policy," Social Science & Medicine, Elsevier, vol. 62(9), pages 2125-2136, May.
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    3. Brydie Clarke & Boyd Swinburn & Gary Sacks, 2018. "Understanding Health Promotion Policy Processes: A Study of the Government Adoption of the Achievement Program in Victoria, Australia," IJERPH, MDPI, vol. 15(11), pages 1-19, October.
    4. Arsenijevic, Jelena & Groot, Wim, 2022. "Health promotion policies for elderly—Some comparisons across Germany, Italy, the Netherlands and Poland," Health Policy, Elsevier, vol. 126(1), pages 69-73.
    5. Nykiforuk, Candace I.J. & McGetrick, Jennifer Ann & Raine, Kim D. & Wild, T. Cameron, 2019. "Advocacy coalition impacts on healthy public policy-oriented learning in Alberta, Canada (2009–2016): A difference-in-differences analysis," Social Science & Medicine, Elsevier, vol. 220(C), pages 31-40.
    6. Fleury, Marie-Josée & Grenier, Guy & Vallée, Catherine & Hurtubise, Roch & Lévesque, Paul-André, 2014. "The role of advocacy coalitions in a project implementation process: The example of the planning phase of the At Home/Chez Soi project dealing with homelessness in Montreal," Evaluation and Program Planning, Elsevier, vol. 45(C), pages 42-49.
    7. Tubbing, Luuk & Harting, Janneke & Stronks, Karien, 2015. "Unravelling the concept of integrated public health policy: Concept mapping with Dutch experts from science, policy, and practice," Health Policy, Elsevier, vol. 119(6), pages 749-759.
    8. Payán, Denise D. & Lewis, LaVonna B. & Cousineau, Michael R. & Nichol, Michael B., 2017. "Advocacy coalitions involved in California's menu labeling policy debate: Exploring coalition structure, policy beliefs, resources, and strategies," Social Science & Medicine, Elsevier, vol. 177(C), pages 78-86.
    9. Clarke, Brydie & Swinburn, Boyd & Sacks, Gary, 2020. "Understanding the LiveLighter® obesity prevention policy processes: An investigation using political science and systems thinking," Social Science & Medicine, Elsevier, vol. 246(C).

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