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.
Similar content being viewed by others
References
Stewart BW, Wild CP, editors. World Cancer Report 2014. Lyon: International Agency for Research on Cancer; 2014.
Gallagher J. ‘Cancer “tidal wave” on horizon, warns WHO’. BBC News: Health, 2 February 2014. www.bbc.co.uk/new/health-26014693.
British Medical Association. Prevention before cure. London: BMA; 2018.
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.
McGrady B. Trade and public health: the WTO, tobacco alcohol, and diet. Cambridge: Cambridge University Press; 2011.
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.
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.
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.
Engelhard CL, Garson A Jr, Dorn S. Reducing obesity: policy strategies from the tobacco wars. 2009. www.urban.org. Washington: Urban Institute.
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.
Kersh R, Morone J. The politics of obesity: seven steps to government action. Health Aff. 2002;21(6):142–53.
Kersh R, Morone J. Obesity, courts, and the new politics of public health. J Health Polit Policy Law. 2005;30(5):839–68.
Weiss RI, Smith JA. Legislative approaches to the obesity epidemic. J Public Health Policy. 2004;25(3):379–90.
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.
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.
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.
Cairney P, Studlar D, Mamudu H. Global tobacco control: power, policy, governance and transfer. Basingstoke: Palgrave; 2012.
Cairney P. Understanding public policy. Basingstoke: Palgrave; 2012.
Enderlein H, Wälti S, Zűrn M. Handbook on multi-level governance. Cheltenham: Edward Elgar; 2010.
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.
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.
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.
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.
Kingdon J. Agendas, alternatives and public policies. New York: Harper Collins; 1984.
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.
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.
Bogart WA. Regulating obesity? Government, society and questions of health. New York: Oxford University Press; 2013.
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.
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.
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.
Mwatsama M. (2016). Public health policy struggles: Comparison of salt reduction and nutrition labelling in the UK, 1980–2015. DrPH Thesis, London School of Hygiene and Tropical Medicine.
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.
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.
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.
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.
Cairney P. The politics of evidence based policymaking. London: Palgrave; 2016.
Studlar DT. Tobacco control: comparative politics in the United States and Canada. Toronto: University of Toronto Press; 2002.
Studlar DT. Punching above their weight through international policy learning: tobacco control policies in Ireland. Irish Political Studies. 2015;30(1):41–78.
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.
Lang T, Heasman M. Food wars: the global battle for mouths, minds and markets. London: Earthscan; 2004.
Baumgartner F, Jones B. Agendas and instability in American politics. Chicago: Chicago University Press; 1993.
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.
Jonsson U and C. Schuftan. 2014.”International Conference on Nutrition. The real issues are being evaded.” World Nutrition 5 (11): 925-928.
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.
Pacheco J. Trends: public opinion on smoking and anti-smoking policies. Public Opin Quarterly. 2011;75(3):576–92.
Bogart WA. Permit but discourage: regulating excessive consumption. New York: Oxford University Press; 2011.
OECD. Health at a glance 2013: OECD indicators. Paris: OECD Publishing; 2013. https://doi.org/10.1787/health_glance-2013-en.
Alemanno A, Gabbi S, editors. Foundations of EU food law and policy. Burlington: Ashgate; 2014.
Lustig RH. Fat chance: beating the odds against sugar, processed food, obesity, and disease. New York: Hudson Street Press; 2013.
Oliver JE, Lee T. Public opinion and the politics of obesity in America. J Health Polit Policy Law. 2005;30(5):923–54.
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.
McKee M, Diethelm P. How the growth of denialism undermines public health. BMJ. 2010;341:c6950. https://doi.org/10.1136/bmj.c6950.
Smith K. Beyond evidence-based policy in public health. Basingstoke: Palgrave Macmillan; 2013.
Emanuel EJ, Steinmetz AP. Finally, some optimism about obesity. New York Times, 4 May 2014.
Garde A. EU law and obesity prevention. The Hague: Kluwer; 2011.
Baggott R. By voluntary agreement: the politics of instrument selection. Public Adm. 1986;64(1):51–67.
Vogel D. Cooperative regulation: environmental protection in Great Britain. Public Interest. 1983;72(Summer):88–106.
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.
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.
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.
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.
Princen S. Agenda-setting in the European Union. Houndsmill, Basingstoke: Palgrave; 2009.
Mamudu H, Studlar DT. Multilevel governance and shared sovereignty: the European Union, Member States, and the FCTC. Governance. 2009;22:73–97.
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.
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.
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.
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.
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.
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.
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.
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.
Nestle M. Food politics: how the food industry influences nutrition and health. Berkeley: University of California Press; 2002.
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.
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.
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.
Leichter H. Free to be foolish: politics and health promotion in the United States and Great Britain. Princeton: Princeton University Press; 1991.
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.
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.
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.
Baggott R. Public Health: Policy and Politics. 2nd ed. London: Palgrave; 2010.
Lang T, Heasman M. Food Wars. 2nd ed. London: Earthscan; 2015.
Author information
Authors and Affiliations
Corresponding author
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Studlar, D., Cairney, P. Multilevel governance, public health and the regulation of food: is tobacco control policy a model?. J Public Health Pol 40, 147–165 (2019). https://doi.org/10.1057/s41271-019-00165-6
Published:
Issue Date:
DOI: https://doi.org/10.1057/s41271-019-00165-6