Challenging Ties between State and Tobacco Industry: Advocacy Lessons from India.

BACKGROUND Globally, tobacco use is a major public health concern given its huge morbidity and mortality burden that is inequitably high in low- and middle-income countries. The World Health Organization has suggested banning the advertisement, promotion and sponsorship of tobacco. However, governments in some countries, including India, are either directly engaged in tobacco industry operations or have a mandate to promote tobacco industry development. This paper analyses a short-term advocacy campaign that challenged the state-tobacco industry ties to draw lessons for effective public health advocacy. METHOD This paper uses a case study method to analyze advocacy efforts in India to thwart the state-tobacco industry partnership: the Indian government's sponsorship and support to a global tobacco industry event. The paper explores multiple strategies employed in the five-month advocacy campaign (May to October 2010) to challenge this state-industry tie. In doing so, we describe the challenges faced and the lessons learnt for effective advocacy. RESULTS Government withdrew participation and financial sponsorship from the tobacco industry event. Use of multiple strategies including engaging all concerned government agencies from the beginning, strategic use of media, presence and mobilization of civil society, and use of legal tools to gain information and judicial action, were complementary in bringing desired outcomes. CONCLUSION Use of multiple and complementary advocacy strategies could lead to positive outcomes in a short-time campaign. The Framework Convention on Tobacco Control could form an important advocacy tool, especially in countries that have ratified it, to advocate for improvements in national tobacco control regulations.