The policy challenges of tobacco control: Implications for public and global health

由健康倡导者、研究人员、资助者和政策制定者组成的联盟最近在英国烟草控制方面取得了惊人的成功，英国各地通过了公共场所无烟立法就是一个缩影。这些成功导致烟草控制被确定为以证据为基础的公共卫生政策的罕见范例，研究、宣传和政策界之间有着密切的联系。在国际上，英国在制定欧盟和世卫组织的烟草控制政策(特别是《世卫组织烟草控制框架公约》)方面发挥了重要作用。由于所有这些原因，有人建议，公共卫生的其他领域可以将烟草控制作为洞察和灵感的来源。与此同时，关于烟草控制对更广泛的公共卫生和社会目标的贡献的问题，对这种成功的叙述提出了挑战。虽然许多人认为烟草控制是减少健康不平等战略的必要核心，但这一观点受到了一些健康不平等研究人员的挑战。吸烟的社会梯度非常持久，人们对低收入吸烟者的污名化表示关切；与此同时，围绕新政策建议的新冲突正在威胁到烟草控制领域长期存在的共识。英国对戒烟的重视也被国际社会批评为促进了烟草控制的医学化。拟议的系列研讨会由资深社会和政治科学家领导，涉及各种相关学科，将探讨这些极具争议性的问题，旨在通过促进跨部门和跨学科的对话，为公共卫生研究和政策的未来提供信息。总体目标是通过探索该领域内出现的紧张局势和分析对公共和全球卫生政策的更广泛影响，增加我们对英国烟草控制政策的经验和未来的了解。该系列活动将围绕烟草控制的三个内部挑战及其对公共卫生政策和全球卫生的影响进行组织。这些挑战将通过重点关注三个主题来探讨，这三个主题对烟草控制至关重要，并在公共和全球卫生政策中提出更广泛的问题：商业部门；不平等；以及治理。该计划的结构将是一系列扩大对话，每年通过三个相互关联的研讨会探讨一个主题：第一年：烟草控制和商业部门1.减少危害：共识的终结？2.将企业监管为应对健康的决定因素？3.英国和全球烟草行业：罪责、责任和人权。第2年：烟草控制和不平等4.通过促进污名化来解决健康不平等问题？5.烟草控制、税收和戒烟：对解决不平等问题的政策的影响。6.烟草管制和千年发展目标以外的发展议程。第3年：控烟治理7.走向终局？制定转型战略面临的挑战。8.促进非传染性疾病战略的政策一致性？烟草、酒精和食品政策方面的教训。9.英国在全球烟草控制方面：是领导者还是问题？每一次活动都将由相关研究、宣传和政策团体提供信息，并将大力强调促进早期职业研究人员的参与。整个系列将使用多种形式，以反映具体问题的独特挑战；所有活动的优先事项将是促进讨论和参与。研讨会将根据查塔姆之家规则举行，公开发表演讲，并在不可归因性的基础上编写摘要、文章和简报。

Tobacco control in the UK has recently experienced striking successes for a coalition of health advocates, researchers, funders and policy makers, epitomised by the passage of legislation for smoke-free public places across the devolved UK. These successes have led to tobacco control being identified as a rare example of evidence-based public health policy, with close links between research, advocacy and policy communities. Internationally, the UK has played significant roles in developing tobacco control policies in the EU and the WHO (notably the WHO Framework Convention on Tobacco Control). For all these reasons, it has been suggested that other areas of public health could look to tobacco control as a source of insight and inspiration.At the same time, this narrative of success is challenged by questions about tobacco control's contribution to broader public health and societal goals. While many regard tobacco control as necessarily central to strategies reduce health inequalities, this view has been challenged by some health inequalities researchers. The social gradient in smoking is remarkably persistent, and concerns have been raised about the stigmatization of low-income smokers; meanwhile, the long-established consensus within tobacco control is being threatened by emerging conflicts over new policy proposals. The UK's emphasis on smoking cessation has also been criticised internationally as contributing to the medicalisation of tobacco control. Led by senior social and political scientists, and involving a variety of relevant disciplines, the proposed seminar series will explore these highly contentious issues and aim to inform the future of public health research and policy by facilitating cross-sector and cross-disciplinary conversations. The overall objective is to increase our understanding of the experience and future of UK tobacco control policy by exploring emergent tensions within the field and analysing wider implications for public and global health policy. The series will be organised around the three spheres of challenges internal to tobacco control and their implications for public health policy and global health. These challenges will be explored via a focus on three themes that are central to tobacco control and raise broader questions across public and global health policy: the commercial sector; inequalities; and governance. The programme will be structured as a series of expanding conversations, with one theme being explored each year via three linked seminars:Year 1: Tobacco control and the commercial sector 1. Harm reduction: the end of consensus? 2. Regulating corporations as tackling the determinants of health? 3. The UK & the global tobacco industry: culpability, liability and human rights. Year 2: Tobacco control and inequalities 4. Tackling health inequalities by promoting stigmatisation? 5. Tobacco control, taxation and cessation: implications for policies to address inequalities. 6. Tobacco control and the development agenda beyond the Millennium Development Goals. Year 3: Tobacco control governance 7. Towards an endgame? Challenges in developing transformational strategies. 8. Towards policy coherence in NCD strategies? Lessons across tobacco, alcohol and food policy. 9. The UK in global tobacco control: leader or problem? Each event will be informed by relevant research, advocacy and policy communities, and there will be a strong emphasis on promoting the participation of early career researchers. Multiple formats will be used across the series to reflect the distinctive challenges of specific issues; the priority of all events will be to enable discussion and participation. Seminars will be held under the Chatham House rule, with presentations made publicly available and summaries, articles and briefings being produced based on non-attributable basis.