BACKGROUND: Monitoring tobacco control policies effectively is crucial to advancing the global fight against tobacco use, as emphasized in the MPOWER framework and the WHO Framework Convention on Tobacco Control (FCTC). However, under-served regions face persistent challenges, such as weak governance, limited resources, and inadequate infrastructure, which impede effective policy tracking and enforcement. Blockchain technology presents a promising solution by providing transparent, tamper-proof, and decentralized systems for monitoring and accountability. This study seeks to critically examine the opportunities and challenges of using blockchain technology to strengthen the "Monitor" (M) component of MPOWER, focusing on implementing and enforcing tobacco control policies in under-served regions.
METHODS: A mixed-methods approach included a systematic review of blockchain applications in public health, regulatory compliance, and policy monitoring. Case studies of blockchain-based initiatives were analyzed to identify best practices and insights relevant to tobacco control. The study also reviewed two major surveys, the Global Adult Tobacco Survey (GATS) and the Global Youth Tobacco Survey (GYTS), to provide additional context. Key barriers and enablers were assessed through content and thematic analysis of leading authorities.
RESULTS: The study reveals that blockchain technology can improve transparency, ensure data integrity, and build stakeholder trust in monitoring tobacco policies. Case studies from other public health domains showcase its scalability and adaptability. However, challenges such as high implementation costs, inadequate technological infrastructure in underserved regions, and the need for stakeholder capacity building persist. Overcoming these barriers will require collaborative efforts between state and non-state actors to implement the technology effectively.
CONCLUSIONS: Blockchain technology offers a transformative opportunity to enhance the monitoring and enforcement of tobacco control policies under the MPOWER framework. Strategic investments in infrastructure, stakeholder engagement, and capacity building are essential to realize its full potential, especially in underserved regions. This study provides practical insights to help policymakers leverage digital solutions to combat tobacco use.