The Campaign for Tobacco-Free Kids (CTFK) helped Bangladesh reduce adult tobacco use by 18.5% between 2009 and 2017. Exposure to second-hand smoke declined significantly in homes (-15.9%) and public spaces, with restaurants and healthcare facilities seeing declines of 30% and 11.1%, respectively. These public health successes are the result of policy changes advocated for by CTFK and its partners in Bangladesh.
THE CHALLENGE
An estimated 16.4% of adults and 14.6% of youth smoke cigarettes in Mexico. Secondhand smoke is a significant problem: 17% of adults are exposed to smoking at their workplace, and almost 26% are exposed in restaurants and on public transport. Nearly half of all youth (44.6%) are exposed to secondhand smoke in public places.1
Multinational tobacco companies have a sizeable presence in the country. Through its Mexican subsidiary, Philip Morris International (PMI) dominates the Mexican cigarette market. British American Tobacco (BAT) ranks second. The tobacco industry’s power and influence in policymaking are deeply entrenched and have stifled any reform to tobacco control laws for more than 13 years.
THE OPPORTUNITY
After ratifying the World Health Organization Framework Convention on Tobacco Control in 2004, Mexico approved the General Law on Tobacco Control in 2008. Unfortunately, the law included significant policy gaps, such as allowing sections for smokers in some public places and did not entirely ban tobacco advertisement.
Mexican states have adopted their own laws, protecting over 60% of the population from secondhand smoke by 2020. Unfortunately, multiple smoke-free bills had been blocked in the national Congress since 2008
In 2018, when President Andrés Manuel López Obrador won the presidential election, tobacco control advocates engaged with newly elected government stakeholders at both national and local levels, including the Undersecretary of Prevention and Health Promotion, Dr. Hugo López-Gatell, who became a key ally of the tobacco control movement.
OUR ROLE
Local civil society organizations Salud Justa, CODICE and Refleacciona—under the umbrella coalition of México Salud-Hable, an alliance of public health organizations—led the advocacy efforts to amend the General Law on Tobacco Control. The Campaign for Tobacco-Free Kids supported the Mexican tobacco control community in significant ways:
Acting as a catalyst that brought together a diverse mix of actors: Tobacco-Free Kids collaborated with local partners to assemble a diverse and broad coalition comprising national and regional tobacco control organizations, operating under México Salud-Hable. The coalition also included governmental scientific institutions, patients, international organizations and international NGOs. This was key in engaging political stakeholders who supported the process and helped confront industry interference.
Technical and legal support: While Salud Justa led the advocacy efforts, Tobacco-Free Kids’ lawyers helped revise the draft bill and advised local partners on how to support the bill’s provisions and respond to tobacco industry attacks during the legislative process.
Communications strategy and message development: Tobacco-Free Kids worked with advocates to develop a communications strategy and create compelling and engaging messages. Using input from focus groups, surveys, a national poll and interviews with key audiences and stakeholders, México Salud-Hable created and conveyed messages tailored to specific audiences, such as members of the parliament, influencers and the public.
Strategic counseling to grantees and partners: Tobacco-Free Kids advised advocates on how to map relevant stakeholders within the government, mobilize champions, engage with decision-makers and fend off tobacco industry attacks.
Advertising placements: Tobacco-Free Kids worked closely with Refleacciona to ensure a successful paid ad strategy. Striking images, compelling messages and clear infographics were used in various media platforms, including newspapers, billboards near the national Congress, subway stations, buses, radio stations and social media. Ads targeted members of the parliament and exposed tobacco industry interference intended to delay the approval of the reform. Mainstream outlets, acknowledging the social impact of the reform, provided discounted rates and pro bono ad space.
Gaining earned media coverage: Media relations were a vital component of the campaign. Journalists played a pivotal role in soliciting the president to support the reform bill. Tobacco-Free Kids helped communication officers at local partner organizations to develop a public relations strategy. Salud Justa organized press conferences at critical junctures of the legislative process, such as when the Chamber of Deputies’ Economic Commission tried to jeopardize the bill, when the Senate’s health committee debated the bill and when the tobacco industry attacked key champions and advocates. The media outreach produced dozens of articles, interviews and op-eds to support the tobacco control reform.
Subnational work: For over a decade, Tobacco-Free Kids supported the local partner CODICE in its advocacy efforts to pass smoke-free laws at the subnational level. During the discussion to amend the national law, CODICE worked to draw support for the reform from subnational leaders. This was key to sensitizing legislators on the impact of the legislation in their specific states and bringing a local flavor to the discussion.
Confronting tobacco industry interference: PMI and BAT subsidiaries relentlessly tried to jeopardize the approval of the reform by leveraging their connections within the parliament to water down or obstruct the reform bill and using front groups or allies (mostly vapers) to attack advocates and political champions or lobby for exemptions to the smoke-free provision for e-cigarettes and heated tobacco products. Tobacco-Free Kids collaborated with advocates to counter tobacco industry interference by highlighting the links between front groups and multinational companies and exposing members of the parliament with close ties to the tobacco industry.
RESULTS
These enthusiastic and tenacious advocacy efforts paid off. On April 29, 2021, Mexico’s Chamber of Deputies overwhelmingly approved the bill. On December 15, the Senate unanimously approved the General Law on Tobacco Control reform. On February 17, 2022, President López Obrador signed the amendment and published it, making Mexico a 100% smoke-free country.
LESSONS LEARNED
The Campaign for Tobacco-Free Kids’ investment and engagement in Mexico demonstrates that committed advocates, politicians and government officials can work together to pass proven tobacco control policies to protect their citizens and save lives. Valuable lessons we have learned include:
1.) Work with a diverse and robust coalition of national and local activists, experts, research institutions and international partners.
2.) Target individual decision-makers in advocacy outreach to win champions, recognize supporters and expose opponents.
3.) Combine earned media relations, paid ads and opinion polls to make the issue relevant in the political arena.
4.) Use simple messages evaluated through focus groups, surveys and interviews to engage with decision-makers and the media.
5.) Engage advocates at the local level to ensure legislators see support for the bill and understand its benefits for their constituents.
6.) Fight back against tobacco industry interference at any stage of the campaign.