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Nguenha N, Rodriguez C, Drope J, Bialous SA, Cunguara B, Lencucha R. Tobacco policy (in)coherence in Mozambique: an examination of national and subnational stakeholder perspectives. Health Policy Plan 2024; 39:333-343. [PMID: 38459919 PMCID: PMC11005848 DOI: 10.1093/heapol/czae010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 01/18/2024] [Accepted: 02/19/2024] [Indexed: 03/11/2024] Open
Abstract
Mozambique ranks fifth on the list of tobacco producing countries in Africa, while also being a Party to the WHO Framework Convention on Tobacco Control (FCTC). Tobacco farming is regarded by some governments as a strategic economic commodity for export and remains deeply entrenched within Mozambique's political and economic landscape. This study uses a qualitative description methodology to identify tensions, conflicts and alignment or misalignment in policy on tobacco across government sectors and levels in Mozambique. We conducted semi-structured qualitative interviews with 33 key informants from sectors across national and subnational levels including health, agriculture, economic and commercial sectors, as well as non-state actors from civil society organizations, the tobacco industry, farmers unions and associations and individual farmers. Incoherence was present across sectoral mandates, perspectives on industry's presence in the country and regions and between FCTC provisions and informant perceptions of tobacco production as a development strategy. Despite tobacco being viewed as an important economic commodity by many informants, there was also widespread dissatisfaction with tobacco from both farmers and some government officials. There were indications of an openness to shifting to a policy that emphasizes alternatives to tobacco growing. The findings also illustrate where points of convergence exist across sectors and where opportunities for aligning tobacco policy with the provisions of the FCTC can occur.
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Affiliation(s)
- Nicole Nguenha
- Global Alliance for Tobacco Control, 1 Nicholas St, Suite 1004, Ottawa, Ontario K1N 7B7, Canada
| | - Charo Rodriguez
- Department of Family Medicine, McGill University, 5858, chemin de la Côte-des-Neiges, Montreal, Quebec H3S 1Z1, Canada
| | - Jeffrey Drope
- Bloomberg School of Public Health, Johns Hopkins University, 615 N Wolfe St, Baltimore, Maryland 21205, USA
| | - Stella Aguinaga Bialous
- School of Nursing and Center for Tobacco Control Research and Education, University of California San Francisco, 2 Koret Way, San Francisco, California 94143, USA
| | - Benedito Cunguara
- Ministry of Economy and Finance, Gabinete de Desenvolvimento do Compacto II, Avenida 10 de Novembro, Praça da Marinha, Nº 929, Maputo 929, Mozambique
| | - Raphael Lencucha
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, 3630 Promenade Sir William Osler, Montreal, Quebec H3G 1Y5, Canada
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Clark M, Cunguara B, Bialous S, Rice K, Drope J, Labonte R, Lencucha R. Foregrounding women and household dynamics to inform Article 17: a qualitative description analysis of tobacco farming households in Mozambique. Tob Control 2023:tc-2022-057881. [PMID: 37402575 DOI: 10.1136/tc-2022-057881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 06/23/2023] [Indexed: 07/06/2023]
Abstract
PURPOSE This paper examines the intrahousehold dynamics between women and men present in tobacco farming households in Mozambique. Attention to the experiences and realities of the smallholder farmers is crucial for understanding approaches to alternative livelihoods. Intrahousehold dynamics can provide important insights into how these households and their members view tobacco production and engage with the political economy of tobacco farming, how they make decisions, and the rationale and values behind these decisions. METHODS Data were collected through single-gender focus group discussions (n=8) with 108 participants (men=57, women=51). Analysis was informed by a qualitative description methodology. This research presents a gender-based analysis examining the perspectives, roles, decision-making processes and desires of female and male tobacco farmers in four key tobacco-growing districts in Mozambique. FINDINGS Throughout this paper, women are found to hold leverage and influence in tobacco farming households, and this leverage is in part gained via the necessity of women's unpaid labour in achieving profitability in tobacco farming. Both women and men are also found to strongly desire and pursue the well-being of the household. CONCLUSION Women hold agency within tobacco-growing households and participate in decision-making processes regarding tobacco agriculture. Women should be included in future tobacco control policies and programmes pertaining to Article 17.
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Affiliation(s)
- Madelyn Clark
- Medicine, Brown University, Providence, Rhode Island, USA
| | - Benedito Cunguara
- Gabinete de Desenvolvimento do Compacto II, Ministry of Economy and Finance, Maputo, Mozambique
| | - Stella Bialous
- School of Nursing and Center for Tobacco Control, University of California San Francisco, San Francisco, California, USA
| | - Kathleen Rice
- Department of Family Medicine, McGill University Faculty of Medicine and Health Sciences, Montreal, Québec, Canada
| | - Jeffrey Drope
- School of Public Health, University of Illinois Chicago School of Public Health, Chicago, Illinois, USA
| | - Ronald Labonte
- School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Raphael Lencucha
- School of Physical and Occupational Therapy, McGill University, Montreal, Québec, Canada
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Wan X, Jin J, Ran S. Willingness of tobacco farmers to accept compensation for tobacco crop substitution in Lichuan City, China. Tob Control 2023; 32:338-343. [PMID: 34535508 DOI: 10.1136/tobaccocontrol-2021-056751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 09/04/2021] [Indexed: 11/03/2022]
Abstract
OBJECTIVE This study, conducted in China, explores tobacco farmers' willingness to accept (WTA) compensation for tobacco crop substitution. METHODS The contingent valuation method was used to elicit farmers' WTA compensation. A face-to-face survey was conducted with 280 tobacco farmers in Lichuan City, China. The standard logit regressions were used to identify the factors that influence farmers' WTA. RESULTS Without compensation, most of the respondents were unwilling to implement tobacco crop substitution. However, if the government provided compensation, the proportion of respondents' willingness for substitution increased to 86.7%. Male tobacco farmers are more likely to accept a given compensation value than female farmers. Older tobacco farmers have a higher probability of accepting compensation. The number of farmers engaged in tobacco growing in a family is negatively associated with the probability of accepting a given compensation amount. Tobacco farmers with greater confidence in the expected benefits of tobacco crop substitution tend to be more willing to accept compensation. The mean WTA estimate was achieved as US$2020.35/ha/year. CONCLUSIONS If appropriate compensation is provided for tobacco farmers, there is a potential to implement the tobacco crop substitution policy in the study area.
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Affiliation(s)
- Xinyu Wan
- State Key Laboratory of Earth Surface Processes and Resource Ecology (ESPRE), Beijing Normal University, Beijing, People's Republic of China
- Faculty of Geographical Science, Beijing Normal University, Beijing, People's Republic of China
| | - Jianjun Jin
- State Key Laboratory of Earth Surface Processes and Resource Ecology (ESPRE), Beijing Normal University, Beijing, People's Republic of China
- Faculty of Geographical Science, Beijing Normal University, Beijing, People's Republic of China
| | - Shenghong Ran
- Institute of Geographical Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, People's Republic of China
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Lencucha R, Drope J, Magati P, Sahadewo GA. Tobacco farming: overcoming an understated impediment to comprehensive tobacco control. Tob Control 2022; 31:308-312. [PMID: 35241604 DOI: 10.1136/tobaccocontrol-2021-056564] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 12/03/2021] [Indexed: 12/24/2022]
Abstract
Tobacco farming has emerged as an important concern for tobacco control advocates. Tobacco-growing countries face unique and important challenges to comprehensive, intersectoral tobacco control. These challenges stem from narratives that position tobacco as an important driver of economic growth and development, perpetuated by tobacco interests with close ties to government decision-making. While the global tobacco control movement has enshrined a commitment to alternatives to tobacco growing, there remain numerous obstacles. Tobacco growing is often situated in contexts with limited markets for other agricultural products, limited knowledge and economic resources to pursue alternatives, and/or a structure that favours industry control over the supply chain, all constraining the decision space of farmers. An evidence-informed approach is necessary to address tobacco supply, including growing, processing, manufacturing and trade, in this complex context. This paper reviews the economic, environmental and policy context of tobacco growing with an emphasis on the past decade of empirical work on the political economy of tobacco supply and introduces strategies to pursue alternatives. This analysis debunks many of the arguments used to perpetuate the narrative of tobacco's prosperity and provides critical insights into the institutional constraints faced by government sectors in pursuing a policy of alternatives.
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Affiliation(s)
- Raphael Lencucha
- School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada
| | - Jeffrey Drope
- University of Illinois at Chicago, Chicago, Illinois, USA
| | - Peter Magati
- Consultant, World Health Organization, Nairobi, Kenya
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Sahadewo GA, Drope J, Li Q, Witoelar F, Lencucha R. In-and-Out of Tobacco Farming: Shifting Behavior of Tobacco Farmers in Indonesia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E9416. [PMID: 33334032 PMCID: PMC7765560 DOI: 10.3390/ijerph17249416] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 12/07/2020] [Accepted: 12/09/2020] [Indexed: 01/01/2023]
Abstract
Understanding the variables that affect farmers' decisions as to whether to grow tobacco and/or other crops provides important insights into their economic lives and can help to inform the development and implementation of policies that shape both tobacco production and tobacco control, such as increasing tobacco excise taxes. This study employs complementary quantitative and qualitative methodologies to identify variables that affect tobacco farmers' economic decision making in Indonesia, a major tobacco producer. The research focuses on the variables that affect tobacco farmers' decisions to continue tobacco farming or shift to non-tobacco farming. It finds that tobacco farmers' decision making is complex but also predictable. The results of the quantitative analysis suggest that farming profits and positive rainfall shocks are two of the key variables that affect the decision to cultivate tobacco. The qualitative results confirm these findings and further illuminate that access to credit, education (agricultural and otherwise) and information play substantial roles in farmers' economic decision making. Most of these variables are affected by the unequal relationship between the tobacco firms that buy tobacco and the farmers, wherein the farmers are consistently at a disadvantage in terms of negotiating key parameters such as prices and evaluation of leaf quality.
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Affiliation(s)
| | - Jeffrey Drope
- Health Policy and Administration, School of Public Health, University of Illinois at Chicago (UIC), Chicago, IL 60608, USA
| | - Qing Li
- Economic & Health Policy Research, Data Science, American Cancer Society, Atlanta, GA 30303, USA;
| | - Firman Witoelar
- Crawford School of Public Policy, Australian National University, Canberra 2600, ACT, Australia;
| | - Raphael Lencucha
- Faculty of Medicine, School of Physical and Occupational Therapy, McGill University, Montreal, QC 3605, Canada;
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Lencucha R, Drope J, Labonte R, Cunguara B, Ruckert A, Mlambo Z, Kadungure A, Bialous S, Nhamo N. The Political Economy of Tobacco in Mozambique and Zimbabwe: A Triangulation Mixed Methods Protocol. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E4262. [PMID: 32549287 PMCID: PMC7345056 DOI: 10.3390/ijerph17124262] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 06/01/2020] [Accepted: 06/08/2020] [Indexed: 12/12/2022]
Abstract
Changing global markets have generated a dramatic shift in tobacco consumption from high-income countries (HICs) to low- and middle-income countries (LMICs); by 2030, more than 80% of the disease burden from tobacco use will fall on LMICs. Propelling this shift, opponents of tobacco control have successfully asserted that tobacco is essential to the economic livelihoods of smallholder tobacco farmers and the economy of tobacco-growing countries. This nexus of economic, agricultural and public health policymaking is one of the greatest challenges facing tobacco control efforts, especially in LMICs. To date, there is a lack of comparative, individual level evidence about the actual livelihoods of tobacco-growing farmers and the political economic context driving tobacco production. This comparative evidence is critically important to identify similarities and differences across contexts and to provide local evidence to inform policies and institutional engagement. Our proposed four-year project will examine the economic situation of smallholder farmers in two major tobacco-growing LMICs-Mozambique and Zimbabwe-and the political economy shaping farmers' livelihoods and tobacco control efforts. We will collect and analyze the existing data and policy literature on the political economy of tobacco in these two countries. We will also implement household-level economic surveys of nationally representative samples of farmers. The surveys will be complimented with focus group discussions with farmers across the major tobacco-growing regions. Finally, we will interview key informants in these countries in order to illuminate the policy context in which tobacco production is perpetuated. The team will develop country-level reports and policy briefs that will inform two sets of dissemination workshops in each country with relevant stakeholders. We will also conduct workshops to present our findings to the survey and focus group participants, and other members of these tobacco-growing communities, so they can directly benefit from the research to which they are contributing.
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Affiliation(s)
- Raphael Lencucha
- Faculty of Medicine, School of Physical and Occupational Therapy, McGill University, 3630 Promenade Sir William Osler, Montreal, QC H3G 1Y5, Canada
| | - Jeffrey Drope
- Economic and Health Policy Research, American Cancer Society, Atlanta, GA 30303, USA;
| | - Ronald Labonte
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON K1G 5Z3, Canada; (R.L.); (A.R.)
| | - Benedito Cunguara
- Independent Researcher, Av Vladmir Lenine #2081, Flat 1.4, Maputo P.O. Box 55, Mozambique;
| | - Arne Ruckert
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON K1G 5Z3, Canada; (R.L.); (A.R.)
| | - Zvikie Mlambo
- Training and Research Support Center, Harare P.O. Box CY 2720, Zimbabwe; (Z.M.); (A.K.)
| | - Artwell Kadungure
- Training and Research Support Center, Harare P.O. Box CY 2720, Zimbabwe; (Z.M.); (A.K.)
| | - Stella Bialous
- Social and Behavioral Sciences Department, School of Nursing, UCSF, San Franscisco, CA 94143, USA;
| | - Nhamo Nhamo
- Institute of Research, Innovation and Technological Solutions, Zimbabwe Open University, Harare P.O. Box MP 1119, Zimbabwe;
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Clark M, Magati P, Drope J, Labonte R, Lencucha R. Understanding Alternatives to Tobacco Production in Kenya: A Qualitative Analysis at the Sub-National Level. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E2033. [PMID: 32204418 PMCID: PMC7143228 DOI: 10.3390/ijerph17062033] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Revised: 03/13/2020] [Accepted: 03/16/2020] [Indexed: 01/22/2023]
Abstract
Tobacco is a key cash crop for many farmers in Kenya, although there is a variety of challenges associated with tobacco production. This study seeks to understand alternatives to tobacco production from the perspective of government officials, extension officers, and farmers at the sub-national level (Migori, Busia, and Meru) in Kenya. The study analyzes data from qualitative key-informant interviews with government officials and extension officers (n = 9) and focus group discussions (FGDs) with farmers (n = 5). Data were coded according to pre-identified categories derived from the research aim, namely, opportunities and challenges of tobacco farming and alternative crops, as well findings that illustrate the policy environment that shapes the agricultural context in these regions. We highlight important factors associated with the production of non-tobacco agricultural commodities, including the factors that shape the ability of these non-agricultural commodities to serve as viable alternatives to tobacco. The results highlight the effect that several factors, including access to capital, markets, and governmental assistance, have on farmer decisions. The results additionally display the structured policy approaches that are being promoted in governmental offices towards agricultural production, as well as the institutional shortcomings that inhibit their implementation at the sub-national level.
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Affiliation(s)
- Madelyn Clark
- Faculty of Medicine, School of Physical and Occupational Therapy, McGill University, 3630 Promenade Sir William Osler, Montreal, QC H3G 1Y5, Canada;
| | - Peter Magati
- School of Economics, University of Nairobi, Nairobi 30197, Kenya;
| | - Jeffrey Drope
- Economic and Health Policy Research, American Cancer Society, Atlanta, GA 30303, USA;
| | - Ronald Labonte
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON K1N 6N5, Canada;
| | - Raphael Lencucha
- Faculty of Medicine, School of Physical and Occupational Therapy, McGill University, 3630 Promenade Sir William Osler, Montreal, QC H3G 1Y5, Canada;
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