Improving the implementation of tobacco control policies in low-and middle-income countries: a proposed framework

Abstract

Although tobacco control policies have been adopted across the globe, effective implementation continues to be a major challenge, particularly in low-income and middle-income countries, where almost 80% of the world's smokers reside. This conceptual framework illustrates the constellation of factors that have been shown to influence implementation fidelity: political commitment, institutional capacity and operational effectiveness, social climate and tobacco industry interference. Researchers and practitioners can use this framework to identify the points of leverage in the implementation process and contribute to actionable knowledge as well as theory development.