BACKGROUND AND IMPLEMENTATION CHALLENGES: Tobacco use in The Gambia remains a pressing public health challenge, contributing to 3.3% of annual deaths and imposing an economic burden of 415.8 million dalasis. Despite the enactment of the Tobacco Control Act (2016) and Regulations (2019), enforcement gaps, limited public awareness, and interference from influential stakeholders hinder progress. Key challenges include non-compliance in tourist development areas and resistance to bans on shisha and electronic cigarettes, underscoring the need for innovative, sustainable approaches to policy implementation and enforcement.
INTERVENTION OR RESPONSE: A collaborative, evidence-based advocacy strategy was launched to address these barriers. Stakeholders - including ministers, parliamentarians, civil society organizations, and international donors such as the African Capacity Building Foundation - worked together to strengthen enforcement mechanisms and mobilize community support. Quarterly operations targeted non-compliant regions, seizing contraband tobacco products and promoting compliance. The establishment of a Tobacco Industry Monitoring Team in 2020 marked a critical step in exposing industry tactics and guiding policy responses. Comprehensive measures, such as 75% graphic health warnings on packaging and bans on advertising, sponsorship, and single-stick sales, were implemented to protect vulnerable populations.
RESULTS AND IMPACT: Advocacy efforts led to measurable declines in youth smoking prevalence and enhanced public awareness. Tax reforms generated substantial revenue ($6.3 million in 2020) for sustainable tobacco control programs. However, enforcement operations revealed ongoing gaps in public compliance and resistance from key stakeholders. Lessons learned informed the development of targeted, community-centered campaigns involving religious leaders, youth, and media, amplifying impact across diverse demographics.
CONCLUSIONS: The Gambia’s experience highlights the transformative potential of coordinated, multisectoral advocacy and enforcement in overcoming systemic barriers to tobacco control. By prioritizing sustainable funding, strengthening enforcement, and fostering global partnerships, governments can build resilient, scalable models for advancing public health and achieving a tobacco-free future.