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在一个中等收入国家实施烟草控制政策的过程中持续参与的重要性:以哥斯达黎加为例。

The importance of continued engagement during the implementation phase of tobacco control policies in a middle-income country: the case of Costa Rica.

作者信息

Crosbie Eric, Sosa Patricia, Glantz Stanton A

机构信息

Center for Tobacco Control Research and Education, University of California San Francisco, San Francisco, California, USA.

Department of Politics, University of California Santa Cruz, Santa Cruz, California, USA.

出版信息

Tob Control. 2017 Jan;26(1):60-68. doi: 10.1136/tobaccocontrol-2015-052701. Epub 2016 Feb 8.

Abstract

OBJECTIVE

To analyse the process of implementing and enforcing smoke-free environments, tobacco advertising, tobacco taxes and health warning labels from Costa Rica's 2012 tobacco control law.

METHOD

Review of tobacco control legislation, newspaper articles and interviewing key informants.

RESULTS

Despite overcoming decades of tobacco industry dominance to win enactment of a strong tobacco control law in March 2012 consistent with WHO's Framework Convention on Tobacco Control, the tobacco industry and their allies lobbied executive branch authorities for exemptions in smoke-free environments to create public confusion, and continued to report in the media that increasing cigarette taxes led to a rise in illicit trade. In response, tobacco control advocates, with technical support from international health groups, helped strengthen tobacco advertising regulations by prohibiting advertising at the point-of-sale (POS) and banning corporate social responsibility campaigns. The Health Ministry used increased tobacco taxes earmarked for tobacco control to help effectively promote and enforce the law, resulting in high compliance for smoke-free environments, advertising restrictions and health warning label (HWL) regulations. Despite this success, government trade concerns allowed, as of December 2015, POS tobacco advertising, and delayed the release of HWL regulations for 15 months.

CONCLUSIONS

The implementation phase continues to be a site of intensive tobacco industry political activity in low and middle-income countries. International support and earmarked tobacco taxes provide important technical and financial assistance to implement tobacco control policies, but more legal expertise is needed to overcome government trade concerns and avoid unnecessary delays in implementation.

摘要

目的

分析哥斯达黎加2012年烟草控制法中无烟环境、烟草广告、烟草税和健康警示标签的实施与执行过程。

方法

审查烟草控制立法、报纸文章并采访关键信息提供者。

结果

尽管历经数十年烟草行业的主导,哥斯达黎加于2012年3月成功颁布了一部与世界卫生组织《烟草控制框架公约》相符的强有力的烟草控制法,但烟草行业及其盟友游说行政部门当局,要求在无烟环境方面给予豁免,从而造成公众困惑,并且继续在媒体上报道提高卷烟税导致非法贸易增加。作为回应,烟草控制倡导者在国际卫生组织的技术支持下,通过禁止在销售点(POS)做广告以及禁止企业社会责任活动,帮助加强了烟草广告法规。卫生部将增加的烟草税专门用于烟草控制,以有效促进和执行该法律,从而使无烟环境、广告限制和健康警示标签(HWL)法规的遵守率很高。尽管取得了这一成功,但截至2015年12月,政府出于贸易方面的考虑,允许销售点进行烟草广告,并将健康警示标签法规的发布推迟了15个月。

结论

在低收入和中等收入国家,实施阶段仍是烟草行业密集开展政治活动的领域。国际支持和专门的烟草税为实施烟草控制政策提供了重要的技术和财政援助,但需要更多的法律专业知识来克服政府贸易方面的顾虑,并避免实施过程中出现不必要的延误。

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