Understanding tobacco control policy at the national level: bridging the gap between public policy and tobacco control advocacy
More details
Hide details
Maastricht University, Health Promotion, Netherlands
Trimbos Institute, Netherlands
Publication date: 2018-03-01
Tob. Induc. Dis. 2018;16(Suppl 1):A449
Download abstract book (PDF)

While some countries have advanced tobacco control policies, other countries struggle to adopt and implement FCTC's measures. This presentation uncovers the main factors that explain such variations, taking insights from public policy and political science as a starting point for a case study.

A case study of tobacco control policy making in the Netherlands, covering the period from the 1960s until the present. The study consisted of a systematic search and analysis of documents and proceedings of parliamentary debates on tobacco policy, supplemented with 22 interviews with key informants from the government, health organisations, politicians, and the tobacco industry. In addition, documents from the Truth Tobacco Industry Documents database, pertaining to the influence of the tobacco industry on Dutch policy making, were analysed.

The Dutch government started relatively late to regulate tobacco. The choices in tobacco control policy making at the national level and the tempo in which they are made are explained by the interaction of the five main elements of the tobacco control policy making process:
  1. Relatively stable context factors (constitutional structures, 'rules of the policy making game', national cultural values)
  2. Relatively dynamic context factors (regime changes, EU regulation and FCTC guidelines, changing social norms, public support)
  3. Transfer of ideas (availability and interpretation of scientific evidence)
  4. Pro and anti-tobacco control networks and coalitions (their organisational and lobby strength)
  5. Agenda-setting (changes in problem definition, issue framing, media advocacy)

Despite worldwide convergence of tobacco control policies, accelerated by the ratification of the FCTC treaty by most nations, governments develop approaches to tobacco control in line with cultural values, ideological preferences and specific national institutional arrangements. There is no one-size-fits-all approach.
The findings will be published in an upcoming book, entitled: Tobacco Control Policy in the Netherlands: Between Economy, Public Health, and Ideology.