Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Applied Physics Laboratory, Johns Hopkins University, USA.
Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Applied Physics Laboratory, Johns Hopkins University, USA.
Soc Sci Med. 2019 Feb;222:188-197. doi: 10.1016/j.socscimed.2019.01.008. Epub 2019 Jan 9.
This paper examines whether country implementation of a public health treaty is influenced by the implementation behaviors of other countries to which they have network ties. We examine implementation of the Framework Convention on Tobacco Control (FCTC) adopted by the World Health Organization in 2003 and ratified by approximately 94% of countries as of 2016. We constructed five networks: (1) geographic distance, (2) general trade, (3) tobacco trade, (4) GLOBALink referrals, and (5) GLOBALink co-subscriptions. Network exposure terms were constructed from these networks based on the implementation scores for six articles of the FCTC treaty. We estimate effects using a lagged Type 1 Tobit model. Results show that network effects were significant: (a) across all networks for article 6 (pricing and taxation), (b) distance, general trade, GL referrals, and GL co-subscriptions for article 8 (second hand smoke), (c) distance, general trade, and GL co-subscriptions for article 11 (packaging and labeling), and (d) distance and GL co-subscription for article 13 (promotion and advertising), (e) tobacco trade and GL co-subscriptions for article 14 (cessation). These results indicate that diffusion effects were more prevalent for pricing and taxation as well as restrictions on smoking in public places and packaging and labeling. These results suggest that network influences are possible in domains that are amenable to control by national governments but unlikely to occur in domains established by existing regulatory systems. Implications for future studies of policy implementation are discussed.
本文探讨了一个国家对公共卫生条约的执行情况是否会受到与其具有网络联系的其他国家执行行为的影响。我们考察了 2003 年世界卫生组织通过并在 2016 年获得约 94%的国家批准的《烟草控制框架公约》（FCTC）的执行情况。我们构建了五个网络：（1）地理距离，（2）一般贸易，（3）烟草贸易，（4）GLOBALink 转介，和（5）GLOBALink 共同订阅。根据 FCTC 条约的六篇文章的执行情况，从这些网络中构建了网络暴露项。我们使用滞后的第一类 Tobit 模型来估计影响。结果表明网络效应是显著的：（a）在所有网络中，第 6 条（定价和税收），（b）距离、一般贸易、GL 转介和 GL 共同订阅第 8 条（二手烟），（c）距离、一般贸易和 GL 共同订阅第 11 条（包装和标签），（d）距离和 GL 共同订阅第 13 条（促销和广告），（e）距离和 GL 共同订阅第 14 条（戒烟）。这些结果表明，扩散效应在定价和税收以及公共场所吸烟限制和包装及标签方面更为普遍。这些结果表明，在国家政府能够控制的领域，网络影响是可能的，但在现有监管系统建立的领域，不太可能发生。讨论了对未来政策执行研究的影响。
