GLOBAL PUBLIC POLICY: DOES THE NEW VENUE FOR TRANSNATIONAL TOBACCO CONTROL CHALLENGE THE OLD WAY OF DOING THINGS?
| Date | 01 December 2015 |
| Published date | 01 December 2015 |
| Author | PAUL CAIRNEY,DONLEY STUDLAR,HADII MAMUDU |
| DOI | http://doi.org/10.1111/padm.12143 |
doi : 10. 1111/p adm .12143
GLOBAL PUBLIC POLICY: DOES THE NEW VENUE FOR
TRANSNATIONAL TOBACCO CONTROL CHALLENGE
THE OLD WAY OF DOING THINGS?
HADII MAMUDU, PAUL CAIRNEY AND DONLEY STUDLAR
The World Health Organization has fostered a new global public policy– the Framework Conven-
tion for Tobacco Control (FCTC). Until the 1980s, tobacco control was the sole preserve of states.
Now, most countries accept the transnational nature of policy. We explain this shift by identifying
mutually reinforcing changes in key policy processelements: transnational actors became a source of
policy learning; an international venue ‘institutionalized’ new policies; networks began to include
tobacco control groups and exclude tobacco companies; socioeconomic shifts undermined public
support, and the economic case, for tobacco; and the dissemination of scientic evidence helped
actors reframe the image of tobacco, from an economic good to a health crisis. These elements
combined to produce an environment conducive to ‘comprehensive’ tobacco control. Yet the imple-
mentation of the FCTC has been slow and uneven, reecting the continued importance of domestic
policy environments, most of which are not conducive to major policy change.
INTRODUCTION: A NEW POLICY ENVIRONMENT FOR GLOBAL TOBACCO
CONTROL
Tobacco control represents one of the most signicant examples of global public policy.
Most countries formally recognize the transnational nature of policy and have made a
commitment to address it at a global level. Many international organizations contribute
to a sense of global policymaking, including the World Conference on Tobacco or Health
(WCTOH), the Organisation for Economic Co-operation and Development (OECD), the
World Bank, and the European Union (EU). The World Health Organization (WHO), in
particular, has emerged as the key player. It has overseen the development of a global
tobacco control policy and is at the heart of efforts to ensure implementation. Yet, there
is a large gap between the global agreement and domestic outcomes, which could take
decades to ll.
In this article, we argue that established policy theory can make a major contribution to
the study of global policy. Although most policy theory is grounded in the study of indi-
vidual states (Stone and Ladi 2015), it has generated ‘universal’ concepts that can be used
to compare global and domestic processes. Rather than testing the value of one theory,
or the comparative value of several, we identify the concepts used by most major theories
to explain policy change – agendas, institutions, networks, socioeconomic conditions, and
ideas (Cairney et al. 2012). These concepts help us guide empirical examination, not only
of domestic, but also of global, policy change.
First, we synthesize ‘evolutionary’ policy theory (including punctuated equilibrium,
multiple streams analysis, and complexity theory) to explain the relationship between pol-
icy environments and policymaker choices.
Second, we argue that a policy environment most conducive to tobacco control can
be found at the global level (and in ‘leading’ countries). We identify the current status
Hadii Mamudu is in the Department of Health Services Management and Policy,East Tennessee State University, John-
son City,Tennessee, USA. Paul Cairney is in the Department of History and Politics, University of Stirling, UK. Donley
Studlar is at the School of Government and Public Policy,University of Strathclyde, Glasgow, UK.
Public Administration Vol.93, No. 4, 2015 (856–873)
© 2015 John Wiley & Sons Ltd.
TRANSNATIONAL TOBACCO CONTROL 857
of global tobacco control, focusing on the WHO as the international organization driv-
ing tobacco control, and the Framework Convention for Tobacco Control (FCTC) as the
treaty setting out a detailed plan. We outline the factors which contributed to a major
change in the policymaking environment. Actors pursuing strong tobacco control poli-
cies are now much more likely to nd a favourable audience than they were before the
1980s. There have been important institutional changes. Responsibility for tobacco control
has shifted from being the sole preserve of individual countries to being led by the WHO.
Unlike trade organizations in the UN, the ‘standard operating procedures’ of the WHO are
geared towards tobacco control. The status of pressure participants has shifted markedly.
The WHO has sought to exclude pro-tobacco groups from the policy process. The socio-
economic context has shifted: tobacco is less likely to be seen as an economic good, and
surveys now demonstrate majority public support for the FCTC.
Tobacco control rose on the global policy agenda, and it is now framed primarily as a
major public health problem. A paradigmatic shift in the way that policymakers under-
stand tobacco, from an economic product to be encouraged, to a harmful practice to be
controlled, has been underpinned by the accumulation and ‘institutionalization’ of the
scientic evidence linking tobacco to ill health. Although we separate these elements of
the policy process analytically, we argue that it is problematic to simply separate their rel-
ative effects or trace the starting point of this transformation to one or several elements – as
is common in, for example, quantitative analysis used to test narrow hypotheses. Rather,
these environmental changes are mutually reinforcing.
Third, we argue that there is an ‘implementation gap’ between the agenda set by the
FCTC and change on the ground. We provide data to demonstrate the size of the gap.
We identify the variable extent to which the policymaking environments in individual
countries are as conducive to change as at the global level. We initially use the devel-
oped/developing country distinction to show how this process is often framed in the
public health literature. However, we do not use economic or democratic development
to explain outcomes – largely because there are too many exceptions to rely on such a gen-
eral explanation. Rather, drawing on policy theory, we identify policy environments that
are more or less conducive to change – contrasting the global environment, and that of
a small number of ‘leading’ countries, with countries such as China and India with less
extensive tobacco control.
Overall, we show that the FCTC marks the beginning of a long and uncertain process,
which is coordinated by the WHO but led by individual states. Consequently, the term
‘global public policy’ should be treated with caution. Currently, it refers to the role of the
FCTC primarily to set the agenda. In many respects, countries are still the main determi-
nants of outcomes, and the policy change envisaged by the WHO could take decades to
produce or fail to materialize.
SAME POLICY CHOICES, DIFFERENT ENVIRONMENTS?
Policymaking environments have a major effect on the development and fate of policy
choices. Most countries support the FCTC, but policymakers in each country face very
different contexts as they proceed with implementation. Our focus shifts from the new
relationships and shared aims in the global arena to the old ways of doing things in domes-
tic politics. This aspect of policymaking is captured well by ‘evolutionary’ theories at the
heart of public policy analysis, including multiple streams analysis, punctuated equilib-
rium theory, and complexity theory (Cairney 2012b). Yet, their references to ‘evolution’
Public Administration Vol.93, No. 4, 2015 (856–873)
© 2015 John Wiley& Sons Ltd.
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