Center for Tobacco Control Research and Education, University of California, San Francisco, CA.
Global Cancer Program, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA.
Nicotine Tob Res. 2020 Dec 12;22(12):2203-2212. doi: 10.1093/ntr/ntaa067.
Nepal passed a comprehensive tobacco control law in 2011. Tobacco control advocates successfully countered tobacco industry (TI) interference to force implementation of law.
Policy documents, news stories, and key informant interviews were triangulated and interpreted using the Policy Dystopia Model (PDM).
The TI tried to block and weaken the law after Parliament passed it. Tobacco control advocates used litigation to force implementation of the law while the TI used litigation in an effort to block implementation. The TI argued that tobacco was socially and economically important, and used front groups to weaken the law. Tobacco control advocates mobilized the media, launched public awareness campaigns, educated the legislature, utilized lawsuits, and monitored TI activities to successfully counter TI opposition.
Both tobacco control advocates and the industry used the discursive and instrumental strategies described in the PDM. The model was helpful for understanding TI activities in Nepal and could be applied to other low- and middle-income countries. Civil society, with the help of international health groups, should continue to track TI interference and learn the lessons from other countries to proactively to counter it.
The PDM provides an effective framework to understand battles over implementation of a strong tobacco control law in Nepal, a low- and middle-income country. The TI applied discursive and instrumental strategies in Nepal in its efforts to weaken and delay the implementation of the law at every stage of implementation. It is important to continuously monitor TI activities and learn lessons from other countries, as the industry often employ the same strategies globally. Tobacco control advocates utilized domestic litigation, media advocacy, and engaged with legislators, politicians, and other stakeholders to implement a strong tobacco control law. Other low- and middle-income countries can adapt these lessons from Nepal to achieve effective implementation of their laws.
尼泊尔于 2011 年通过了一项全面的烟草控制法。烟草控制倡导者成功地抵制了烟草业（TI）的干扰，迫使该法律得以实施。
使用政策困境模型（PDM）对政策文件、新闻报道和关键知情人访谈进行三角分析和解释。
议会通过该法案后，TI 试图阻止并削弱该法律。烟草控制倡导者利用诉讼来强制实施该法律，而 TI 则利用诉讼来阻止该法律的实施。TI 声称烟草在社会和经济上非常重要，并利用前团体来削弱该法律。烟草控制倡导者动员媒体、开展公众意识运动、教育立法机构、利用诉讼以及监测 TI 活动，成功地抵制了 TI 的反对。
烟草控制倡导者和行业都使用了 PDM 中描述的话语和工具策略。该模型有助于理解尼泊尔 TI 的活动，也可以应用于其他低收入和中等收入国家。在国际卫生组织的帮助下，民间社会应继续跟踪 TI 的干扰，并从其他国家吸取经验教训，积极抵制这种干扰。
PDM 为理解在尼泊尔这样一个低收入和中等收入国家实施强有力的烟草控制法的斗争提供了一个有效的框架。TI 在实施该法律的每一阶段都应用了话语和工具策略，以削弱和延迟该法律的实施。不断监测 TI 的活动并从其他国家吸取经验教训非常重要，因为该行业在全球范围内经常采用相同的策略。烟草控制倡导者利用国内诉讼、媒体宣传，并与立法者、政治家和其他利益相关者接触，实施了强有力的烟草控制法。其他低收入和中等收入国家可以借鉴尼泊尔的这些经验教训，以实现其法律的有效实施。
