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Multilevel governance, public health and the regulation of food: is tobacco control policy a model?

  • Donley Studlar
  • Paul CairneyEmail author
Original Article

Abstract

Campaigns against risk factors for non-communicable diseases (NCDs) caused by smoking and obesity have become increasingly common on multiple levels of government, from the local to the international. Non-governmental actors have cooperated with government bodies to make policies. By analysing the policies of the World Trade Organization, the World Health Organization, the European Union, and the United Kingdom and United States governments, we identify how the struggles between public health advocates and commercial interests reached the global level, and how the relatively successful fight to ‘denormalize’ tobacco consumption has become a model for anti-obesity advocates. It highlights three factors important in policy change: framing the policy problem, the policymaking environment and ‘windows of opportunity’—to analyse the struggle between ‘harm regulation’ and ‘neoprohibition’ approaches to an international obesity prevention regime.

Keywords

Tobacco control Food policy Policy process Policy learning Framing Multiple stream analysis 

Notes

References

  1. 1.
    Stewart BW, Wild CP, editors. World Cancer Report 2014. Lyon: International Agency for Research on Cancer; 2014.Google Scholar
  2. 2.
    Gallagher J. ‘Cancer “tidal wave” on horizon, warns WHO’. BBC News: Health, 2 February 2014. www.bbc.co.uk/new/health-26014693.
  3. 3.
    British Medical Association. Prevention before cure. London: BMA; 2018.Google Scholar
  4. 4.
    Steel N, et al. Changes in health in the countries of the UK and 150 English Local Authority areas 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet. 2018;392(10158):1647–61.CrossRefGoogle Scholar
  5. 5.
    McGrady B. Trade and public health: the WTO, tobacco alcohol, and diet. Cambridge: Cambridge University Press; 2011.CrossRefGoogle Scholar
  6. 6.
    Swinburn BA, Sacks G, Hall KD, McPherson K, Finegold DT, Moodie ML, Gortmaker SL. The global obesity pandemic: shaped by global drivers and local environments. Lancet. 2011;378(9793):804–14.  https://doi.org/10.1016/S0140-6736(11)60813-1.CrossRefGoogle Scholar
  7. 7.
    Gilmore A, Savell E, Collin J. Public Health, corporations and the new responsibility deal; promoting partnerships with the vectors of disease? J Public Health. 2011;33(1):2–4.  https://doi.org/10.1093/pubmed/fdr008.CrossRefGoogle Scholar
  8. 8.
    Jacobsen H. Policy responses to obesity failing, EU experts admit. EurActiv.com, June 20. 2013. http://www.euractiv.com/health/eu-policy-responses-obesity-lack-news-528709. Accessed 28 Nov 2018.
  9. 9.
    Engelhard CL, Garson A Jr, Dorn S. Reducing obesity: policy strategies from the tobacco wars. 2009. www.urban.org. Washington: Urban Institute.
  10. 10.
    Klein JD, Dietz W. Childhood obesity: the new tobacco. Health Aff. 2010;29(3):388–92. http://content.healthaffairs.org/content/29/3/388.full.
  11. 11.
    Kersh R, Morone J. The politics of obesity: seven steps to government action. Health Aff. 2002;21(6):142–53.CrossRefGoogle Scholar
  12. 12.
    Kersh R, Morone J. Obesity, courts, and the new politics of public health. J Health Polit Policy Law. 2005;30(5):839–68.CrossRefGoogle Scholar
  13. 13.
    Weiss RI, Smith JA. Legislative approaches to the obesity epidemic. J Public Health Policy. 2004;25(3):379–90.CrossRefGoogle Scholar
  14. 14.
    Brownell KD, Warner KE. The perils of ignoring history: big tobacco played dirty and millions died. How similar is big food? Milbank Q. 2009;87(1):259–94.  https://doi.org/10.1111/j.1468-0009.2009.00555.x.CrossRefGoogle Scholar
  15. 15.
    Alemanno A, Garde A. The emergence of an EU lifestyle policy: the case of alcohol, tobacco and unhealthy diets. Common Mark Law Rev. 2013;50(6):1745–86.Google Scholar
  16. 16.
    Lien G, Deland K. Translating the Framework Convention on Tobacco Control (FCTC): can we use tobacco control as model for other non-communicable disease control? Public Health. 2011;125(12):847–53.  https://doi.org/10.1016/j.puhe.2011.09.022.CrossRefGoogle Scholar
  17. 17.
    Cairney P, Studlar D, Mamudu H. Global tobacco control: power, policy, governance and transfer. Basingstoke: Palgrave; 2012.CrossRefGoogle Scholar
  18. 18.
    Cairney P. Understanding public policy. Basingstoke: Palgrave; 2012.CrossRefGoogle Scholar
  19. 19.
    Enderlein H, Wälti S, Zűrn M. Handbook on multi-level governance. Cheltenham: Edward Elgar; 2010.CrossRefGoogle Scholar
  20. 20.
    Studlar DT. cancer prevention through stealth: science, policy advocacy, and multilevel governance in the establishment of a ‘National Tobacco Control Regime’ in the United States. J Health Polit Policy Law. 2014;39(3):505–35.CrossRefGoogle Scholar
  21. 21.
    Gostin LO. Bloomberg’s health legacy: urban innovator or meddling nanny? Hastings Cent Rep. 2013;43(5):19–25.  https://doi.org/10.1002/hast.208.CrossRefGoogle Scholar
  22. 22.
    Sisnowski J, Street JM, Braunack-Mayer A. Targeting population nutrition through municipal health and food policy: implications of New York City’s experiences in regulatory obesity prevention. Food Policy. 2016;58(1):24–34.CrossRefGoogle Scholar
  23. 23.
    Cairney P, Yamazaki M. A comparison of tobacco policy in the UK and Japan: if the scientific evidence is identical, why is there a major difference in policy? J Comp Policy Anal. 2018;20(3):253–68.Google Scholar
  24. 24.
    Kingdon J. Agendas, alternatives and public policies. New York: Harper Collins; 1984.Google Scholar
  25. 25.
    Studlar DT, Cairney P. Conceptualizing punctuated and non-punctuated policy change: tobacco control in comparative perspective. Int Rev Adm Sci. 2014.  https://doi.org/10.1177/0020852313517997.Google Scholar
  26. 26.
    Cairney P. The transformation of UK tobacco control. In: Compton M, ‘t Hart P, editors. Great policy successes: how governments get it right in a big way at least some of the time. Oxford: Oxford University Press; 2019.Google Scholar
  27. 27.
    Bogart WA. Regulating obesity? Government, society and questions of health. New York: Oxford University Press; 2013.CrossRefGoogle Scholar
  28. 28.
    Shaw E. Le New Labour à la recherché de la meillure relation possible entre les individus l’Etat le marche. Crit Int. 2009;43(2):51–68.CrossRefGoogle Scholar
  29. 29.
    Walters S, Owen G. Labour’s nanny state plan for drinkers, smokers and “unhealthy” eaters sparks revolt in party. Mail Online, 3 May 2014. http://www.dailymail.co.uk/news/article-2619655/Labours-nanny-state-plan.
  30. 30.
    Hyseni L, Elliot-Green A, Lloyd-Williams F, Kypridemos C, O’Flaherty M, McGill R, et al. Systematic review of dietary salt reduction policies: Evidence for an effectiveness hierarchy? PLoS ONE. 2017.  https://doi.org/10.1371/journal.pone.0177535.Google Scholar
  31. 31.
    Mwatsama M. (2016). Public health policy struggles: Comparison of salt reduction and nutrition labelling in the UK, 19802015. DrPH Thesis, London School of Hygiene and Tropical Medicine.Google Scholar
  32. 32.
    BBC News: Health. Poll shows most want sugary drinks banned from UK schools, 4 May 2014. http://www.bbc.com/news/health-27254780. Accessed 29 Nov 2018.
  33. 33.
    Alemanno A, Carreño I. Fat taxes in the EU between fiscal austerity and the fight against obesity. Eur J Risk Regul. 2011;2(4):571–6.CrossRefGoogle Scholar
  34. 34.
    Hiilamo H, Crosbie E, Glantz SA. The evolution of health warning labels on cigarette packs: the role of precedents, and tobacco industry strategies to block diffusion. Tobacco Control. 2012;100:100.  https://doi.org/10.1136/tobaccocontrol-2012-050541.Google Scholar
  35. 35.
    Holehouse, M. Cost of obesity, drug abuse and alcoholism to be revealed. Daily Telegraph, 28 July 2015. http://www.telegraph.co.uk/news/health/news/11769531/Cost-of-obesity-drug-abuse-and-alcoholism-to-be-revealed.html. Accessed 15 Nov 2018.
  36. 36.
    Cairney P. The politics of evidence based policymaking. London: Palgrave; 2016.Google Scholar
  37. 37.
    Studlar DT. Tobacco control: comparative politics in the United States and Canada. Toronto: University of Toronto Press; 2002.Google Scholar
  38. 38.
    Studlar DT. Punching above their weight through international policy learning: tobacco control policies in Ireland. Irish Political Studies. 2015;30(1):41–78.CrossRefGoogle Scholar
  39. 39.
    Mamudu H, Cairney P, Studlar DT. Global Public Policy: does the new venue for transnational tobacco control challenge the old way of doing things? Public Administration. 2015;93:856–73.  https://doi.org/10.1111/padm.12143.CrossRefGoogle Scholar
  40. 40.
    Lang T, Heasman M. Food wars: the global battle for mouths, minds and markets. London: Earthscan; 2004.Google Scholar
  41. 41.
    Baumgartner F, Jones B. Agendas and instability in American politics. Chicago: Chicago University Press; 1993.Google Scholar
  42. 42.
    Dobbs R, Sawers C, Thompson F, Manyika J, Woetzel J, Child P, McKenna S, Spatharouu A. Overcoming obesity: an initial economic analysis. McKinsey Global Institute, November 2014.Google Scholar
  43. 43.
    Jonsson U and C. Schuftan. 2014.International Conference on Nutrition. The real issues are being evaded.” World Nutrition 5 (11): 925-928.Google Scholar
  44. 44.
    WHO. Global Status Report on non-communicable diseases. Geneva: World Health Organization. 2014. http://apps.who.int/iris/bitstream/10665/148114/1/9789241564854_eng.pdf Accessed November 28, 2018.
  45. 45.
    Pacheco J. Trends: public opinion on smoking and anti-smoking policies. Public Opin Quarterly. 2011;75(3):576–92.CrossRefGoogle Scholar
  46. 46.
    Bogart WA. Permit but discourage: regulating excessive consumption. New York: Oxford University Press; 2011.Google Scholar
  47. 47.
    OECD. Health at a glance 2013: OECD indicators. Paris: OECD Publishing; 2013.  https://doi.org/10.1787/health_glance-2013-en.Google Scholar
  48. 48.
    Alemanno A, Gabbi S, editors. Foundations of EU food law and policy. Burlington: Ashgate; 2014.Google Scholar
  49. 49.
    Lustig RH. Fat chance: beating the odds against sugar, processed food, obesity, and disease. New York: Hudson Street Press; 2013.Google Scholar
  50. 50.
    Oliver JE, Lee T. Public opinion and the politics of obesity in America. J Health Polit Policy Law. 2005;30(5):923–54.CrossRefGoogle Scholar
  51. 51.
    Oreskes N, Conway EM. Merchants of doubt: How a handful of scientists obscured the truth on issues from tobacco smoke to global warming. New York: Bloomsbury Press; 2010.Google Scholar
  52. 52.
    McKee M, Diethelm P. How the growth of denialism undermines public health. BMJ. 2010;341:c6950.  https://doi.org/10.1136/bmj.c6950.CrossRefGoogle Scholar
  53. 53.
    Smith K. Beyond evidence-based policy in public health. Basingstoke: Palgrave Macmillan; 2013.CrossRefGoogle Scholar
  54. 54.
    Emanuel EJ, Steinmetz AP. Finally, some optimism about obesity. New York Times, 4 May 2014.Google Scholar
  55. 55.
    Garde A. EU law and obesity prevention. The Hague: Kluwer; 2011.Google Scholar
  56. 56.
    Baggott R. By voluntary agreement: the politics of instrument selection. Public Adm. 1986;64(1):51–67.CrossRefGoogle Scholar
  57. 57.
    Vogel D. Cooperative regulation: environmental protection in Great Britain. Public Interest. 1983;72(Summer):88–106.Google Scholar
  58. 58.
    Borys JM, et al. EPODE approach for childhood obesity prevention: methods, progress and international development. Obes Rev. 2012;13(5):299–315.  https://doi.org/10.1111/j.1467-789X.2011.00950.x.CrossRefGoogle Scholar
  59. 59.
    Chan, M. Health has an obligatory place on any post-2015 agenda. Address to the Sixty-seventh World Health Assembly, Geneva, Switzerland, 19 May 2014. http://www.who.int/dg/speeches/2014/wha-19052014/en Accessed 28 Nov 2018.
  60. 60.
    Friant-Perrot M, Garde A. From BSE to obesity: EFSA’s growing role in the EU’s nutrition policy. In: Alemanno A, Gabbi S, editors. Foundations of EU food law and policy. Burlington: Ashgate; 2014. p. 135–53.Google Scholar
  61. 61.
    Kurzer P. Non-communicable diseases; the EU declares war on “fat”. In: Greer SL, Kurzer P, editors. European Union Public Health Policy: regional and global trends. London: Routledge; 2012. p. 155–67.Google Scholar
  62. 62.
    Princen S. Agenda-setting in the European Union. Houndsmill, Basingstoke: Palgrave; 2009.CrossRefGoogle Scholar
  63. 63.
    Mamudu H, Studlar DT. Multilevel governance and shared sovereignty: the European Union, Member States, and the FCTC. Governance. 2009;22:73–97.CrossRefGoogle Scholar
  64. 64.
    WHO. Global strategy on diet, physical activity and health. Geneva: World Health Organization. 2014. http://www.who.int/dietphysicalactivity/strategy/eb11344/strategy_english_web.pdf. Accessed 28 Nov 2018.
  65. 65.
    Cooper, K. The UN High-level meeting on the prevention and control of NCDs (New York, 19–20 September 2011) and Associated events. C3 Collaborating for Health. 2011. http://www.c3health.org/wp-content/uploads/2009/09/Complete-write-up-of-UN-HLM-and-side-events-v-2-20111108.pdf. Accessed 28 Nov 2018.
  66. 66.
    Johnson, T. Interview with Thomas Bollyky: UN High-level meeting on NCDs: one year later. Council on Foreign Relations, 19 September 2012. http://www.cfr.org/diseases-noncommunicable/un-high-level-meeting-ncds-one-year-later/p29090 Accessed 28 Nov 2018.
  67. 67.
    WHO. Fiscal policies for diet and prevention of noncommunicable diseases (NCDs). Geneva, 5–6 May 2015. 2016. http://www.who.int/dietphysicalactivity/publications/fiscal-policies-diet-prevention/en/. Accessed 14 Nov 2018.
  68. 68.
    FAO. ICN2: second international conference on nutrition: better nutrition, better lives. Rome: FAO, November 2014. p. 19–21. http://www.fao.org/about/meetings/icn2/en/. Accessed 28 Nov 2018.
  69. 69.
    Knapton S. Sugar is as dangerous as alcohol and tobacco warn health experts. Daily Telegraph, 9 January 2014. http://www.telegraph.co.uk/health/healthnews/10559671/Sugar-is-as-dangerous-as-alcohol-and-tobacco-warn-health-experts.html. Accessed 28 Nov 2018.
  70. 70.
    Vartanian LR, Schwartz MB, Brownell KD. Effects of soft drink consumption on nutrition and health: a systematic review and meta-analysis. Am J Public Health. 2007;97(4):667–75.CrossRefGoogle Scholar
  71. 71.
    WHO. Diet, nutrition and the prevention of chronic diseases. Report of a Joint WHO/FAO Expert Consultation. WHO Technical Report Series 916. 2003. http://whqlibdoc.who.int/trs/who_trs_916.pdf. Accessed 28 Nov 2018.
  72. 72.
    Nestle M. Food politics: how the food industry influences nutrition and health. Berkeley: University of California Press; 2002.Google Scholar
  73. 73.
    Campbell N. Dissidents and dietary sodium: concerns about the commentary by Donnell et al., letter to the editor. Int J Epidemiol. 2016.  https://doi.org/10.1093/ije/dyw292.Google Scholar
  74. 74.
    Thornton, J. The UK has introduced a sugar tax, but will it work? London School of Hygiene and Tropical Medicine, June 2018. www.ishtm.ac.uk. Accessed 15 Nov 2018.
  75. 75.
    Larsen LT. The leap of faith from disease treatment to lifestyle prevention: the genealogy of a policy idea. J Health Polit Policy Law. 2012;37(2):227–52.  https://doi.org/10.1215/03616878-1538611.CrossRefGoogle Scholar
  76. 76.
    Leichter H. Free to be foolish: politics and health promotion in the United States and Great Britain. Princeton: Princeton University Press; 1991.CrossRefGoogle Scholar
  77. 77.
    Mayes R, Oliver TR. Chronic disease and the shifting focus of public health: is prevention still a political lightweight? J Health Polit Policy Law. 2012;37(2):181–200.  https://doi.org/10.1215/03616878-1538593.CrossRefGoogle Scholar
  78. 78.
    Mamudu HM, Gonzalez M, Glantz SA. The nature, scope and development of the global tobacco control epistemic community. Am J Public Health. 2011;101(11):2044–54.CrossRefGoogle Scholar
  79. 79.
    Consumers International and World Obesity Federation. Recommendations towards a global convention to protect and promote healthy diets. May 2014. http://www.worldobesity.org/site_media/uploads/Convention_on_Healthy_Diets_FINAL.pdf. Accessed 28 Nov 2018.
  80. 80.
    Baggott R. Public Health: Policy and Politics. 2nd ed. London: Palgrave; 2010.Google Scholar
  81. 81.
    Lang T, Heasman M. Food Wars. 2nd ed. London: Earthscan; 2015.CrossRefGoogle Scholar

Copyright information

© Springer Nature Limited 2019

Authors and Affiliations

  1. 1.Department of Health Services Management and Policy, College of Public HealthEast Tennessee State UniversityJohnson CityUSA
  2. 2.Division of History and PoliticsUniversity of StirlingStirlingUK

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