Advancing, evaluating and defending tobacco control policies through research: Examples from the ITC Project

Geoffrey T. Fong, University of Waterloo

Since 2002, the International Tobacco Control Policy Evaluation Project (ITC Project) has conducted longitudinal cohort surveys across 29 countries covering over two-thirds of the world’s tobacco users; this includes the 6 EU countries of the EUREST-PLUS research project. A central objective of the ITC Project is to evaluate the behavioral and psychosocial impact of national-level tobacco control policies of the WHO Framework Convention on Tobacco Control (FCTC) and to disseminate research findings in ways that support governments in making effective tobacco control policy decisions.

ITC dissemination activities have been recognized for their policy impact by the American Association for Public Opinion Research, the Canadian Institutes for Health Research, and the WHO. ITC Project evaluations of FCTC policies have provided evidence to strengthen and accelerate the implementation of global tobacco control policies across all stages of the public policy cycle.

This presentation begins with recently published analyses showing the dose-response effect of strong implementation of key demand-reduction FCTC policies (corresponding to WHO’s POWER policies) in reducing smoking prevalence, coupled with the very low rates of implementation, which has contributed to the now shifting focus of the FCTC COP toward stronger and swifter implementation. This shift toward implementation elevates the importance of evidence from policy evaluation studies.

The presentation then describes case studies of how ITC evaluation studies have indeed advanced tobacco control at various stages including: 1) documenting the need for stronger health warnings in Canada, the US, and China and to support the adoption of plain packaging in the UK; 2) shaping revisions to the tax structure in Kenya and documenting support for endgame policies under consideration in Canada; 3) evaluating the impact of strong vs. weak policy implementation (e.g., Malaysia’s pictorial warnings compared to China’s text warnings, and comprehensive smoke-free laws in Ireland and other ITC countries compared to partial bans in China).

The presentation will also describe how ITC research has provided key evidence to support countries defending against legal challenges (e.g., Uruguay defending key policies against Philip Morris International’s bilateral investment treaty challenge, and Australia’s defense of plain packaging at the World Trade Organization). These case studies will cover how ITC research evidence is used to advance tobacco control in countries that have not yet implemented key FCTC policies, as well as to support countries with well-established tobacco control policies to promote stronger policies and inform the possible development of endgame strategies.

Geoffrey Fong is a Professor of Psychology and Public Health at the University of Waterloo, and Senior Investigator at the Ontario Institute for Cancer Research. Dr. Fong is the Founder and Principal Investigator of the International Tobacco Control Policy Evaluation Project—the ITC Project—a research consortium of over 150 researchers across 29 countries, covering over two-thirds of the world’s tobacco users. Dr. Fong has served as an expert for the WHO and for many countries across a broad range of tobacco policy domains, including health warnings, smoke-free laws, additives and flavourings, and plain/standardised packaging. Dr. Fong was an expert for Australia and Uruguay in their successful defenses of tobacco control policies that were challenged via trade treaties. Among Dr. Fong’s awards are a 2013 WHO World No Tobacco Day Award, a 2015 Luther L. Terry Award for Outstanding Research Contribution, the 2017 Policy Impact Award from the American Association for Public Opinion Research, and the 2019 John Slade Award from the Society for Research on Nicotine and Tobacco. He is a Fellow of the Royal Society of Canada and the Canadian Academy of Health Sciences.