Study protocol_Assessment of Tobacco Control Policy implementation in Togo_2023_V2.0.pdf
Creators: name: FANTOGNON, Kokou Agbéko Jean-Paul
name: Ku, Grace Marie V.
Publisher: name: figshare
Year: 2023
Subjects: Social determinants of health
Public health not elsewhere classified

description: Tobacco consumption is one of the world’s biggest health problems. Globally, tobacco use is responsible for more than eight million deaths each year, of which more than one million are due to exposure to second-hand smoke. This number is projected to exceed 10 million by 2030 if no actions are taken. Most of these deaths will occur in low and middle-income countries (LMICs), particularly in Africa, which is becoming an attractive market for the tobacco industry as smoking rates decline in high-income countries. This situation is accentuated by the high proportion of young people who are susceptible to aggressive advertising by tobacco companies in LMICs. In this regard, World Health Organization (WHO) Member States adopted the WHO Framework Convention on Tobacco Control (WHO FCTC) in 2003, to tackle the tobacco epidemic. The WHO FCTC is a global treaty established by the World Health Organization (WHO) as an international legal instrument designed to address the global tobacco epidemic and reduce the harm caused by tobacco use. In 2008, a package of six tobacco control measures that have been found effective in reducing tobacco consumption was established to help Member States to fulfil the various provisions of the WHO FCTC. This package, called the WHO MPOWER framework, comprises <strong>m</strong>onitoring tobacco use and prevention policies; <strong>p</strong>rotecting people from tobacco smoke; <strong>o</strong>ffering help to quit tobacco use; <strong>w</strong>arning about the dangers of tobacco; <strong>e</strong>nforcing bans on tobacco advertising, promotion and sponsorship; and <strong>r</strong>aising taxes on tobacco products. While the FCTC has led to significant progress in tobacco control throughout the world, progress in Africa has been slow with modest results. This is mainly due to the influence of the tobacco industry which interferes with the adoption and implementation of tobacco control policies in many African countries where there is a lack of enforcement and weak institutions to guide this process. Nonetheless, some countries have made significant progress in tackling the tobacco epidemic by strengthening the implementation of the WHO FCTC. Tobacco control measures have been applied in Togo for several years. However, the existing laws seem to be dysfunctional and have led to an increasing number of young, particularly students, who are taking up smoking (8). Currently, there is limited evidence on the implementation status of tobacco control policies and how it affects the smoking prevalence and tobacco consumption in Togo. Hence, this study aims to assess the status of Tobacco Control Policies implementation in Togo to date, the potential implementation gaps and the opportunities for moving forward. To the best of our knowledge, tobacco control policy implementation using the WHO MPOWER framework has not yet been done in Togo. A meaningful and comprehensive overview of the state of tobacco control policy implementation in Togo, as measured through the MPOWER framework, will be useful to health researchers, policymakers, and implementers in this country. We aim to evaluate the implementation of tobacco control policies in Togo using the WHO MPOWER framework; specifically, 1. to have an inventory of and describe tobacco policies and laws enacted in Togo since signing the WHO FCTC 2. to measure the extent of the tobacco control policies implementation, through time, in Togo using the WHO MPOWER framework 3. to identify and document gaps in the implementation of tobacco control policies 4. to propose strategic approaches to address identified gaps. This study is exploratory and descriptive; and performed mainly from a constructivist point of view. The study is designed as a multi-stage case study, using a mixed-methods approach, as follows: <strong>Stage 1:</strong> a desk review to have an inventory of tobacco control-related policies in Togo (objective 1) complemented with qualitative methods (key informant interviews and non-structured observation). <strong>Stage 2:</strong> an assessment of the implementation of the tobacco control policies based on the WHO MPOWER framework (objectives 2, 3 and 4) <strong>Stage 3:</strong> a case study by narrowing down on a particular tobacco control policy that “did not achieve targets”, to analyse how it can be improved or what strategies can be put in place to improve implementation (objectives 3 and 4).