Cairney Paul, Mamudu Hadii
Department of History and Politics, University of Stirling, Pathfoot, Stirling, FK94LU, UK.
Department of Health Services Management and Policy, College of Public Health, East Tennessee State University, S. Dossett Drive, Lamb Hall, P.O. Box 70264, Johnson City, TN, 37614, USA.
J Public Health Policy. 2014 Nov;35(4):506-17. doi: 10.1057/jphp.2014.18. Epub 2014 May 15.
The World Health Organization (WHO) Framework Convention for Tobacco Control (FCTC) has prompted major change in tobacco control globally. However, policy implementation has been uneven, making 'smoke free' outcomes possible in some countries, but not others. We identify the factors that would improve implementation. We describe an ideal type of 'comprehensive tobacco control regimes', where policy environments are conducive to the implementation of tobacco control measures designed to eradicate tobacco use. The ideal type requires that a country have certain policy processes: the department of health takes the policy lead; tobacco is 'framed' as a public health problem; public health groups are consulted at the expense of tobacco interests; socioeconomic conditions are conducive to policy change; and, the scientific evidence is 'set in stone' within governments. No country will meet all these criteria in the short term, and the gap between the ideal type and the current state is wide in many countries. However, the WHO experience provides a model for progress.
世界卫生组织（WHO）的《烟草控制框架公约》（FCTC）推动了全球烟草控制方面的重大变革。然而，政策实施情况并不均衡，使得一些国家能够实现“无烟”成果，而另一些国家则不然。我们确定了有助于改善实施情况的因素。我们描述了一种理想类型的“全面烟草控制制度”，即政策环境有利于实施旨在根除烟草使用的烟草控制措施。这种理想类型要求一个国家具备某些政策流程：卫生部门发挥政策主导作用；将烟草“界定”为公共卫生问题；以牺牲烟草利益为代价咨询公共卫生团体；社会经济状况有利于政策变革；并且，科学证据在政府内部“确定无疑”。短期内没有哪个国家能满足所有这些标准，而且在许多国家，理想类型与当前状况之间的差距很大。然而，世卫组织的经验提供了取得进展的模式。
