Framing tobacco control: the case of the Nigerian tobacco tax debates.

Studies have shown that the tobacco industry exerts significant policy-framing efforts to undermine tobacco control (TC) policies. However, most of this evidence is from high-income settings. This study applies framing analysis to the debate surrounding the 2016 tobacco import duty raise in Nigeria and subsequent rise in excise duty on tobacco, alcohol and selected food products in 2018 to understand why policy changes occurred. Print media documents and relevant actor publications published between 2016 and 2018 were analysed interpretively to identify key actors and arguments for and against the tax raise. Key opponents included tobacco companies, trade groups and allies. In contrast, the Ministries of Health and Finance, non-governmental organizations and international bodies like the World Health Organization advocated for the policy. The framing efforts of opponents were largely coordinated with significant alcohol industry involvement, while TC advocates lacked a unified front. Actors on both sides of the debate predominantly focused on economic and 'global ranking' arguments, and advocates also employed health and 'vulnerable groups' framing among others. The tax policy was sustained despite the framing and litigation efforts of opponents, and this is attributed principally to economic factors. The findings also suggest that tobacco is grouped with less harmful products, and advocates need to intensify efforts to diminish this legitimacy in low- and middle-income country settings. Additionally, there may be some benefits to jointly addressing alcohol and TC in this setting. Summarily, it is recommended that public health advocates coordinate their framing efforts to better articulate clear policy positions to the government, gain public support and ensure full Framework Convention on Tobacco Control compliance.

Mapping discourse coalitions in the minimum unit pricing for alcohol debate: a discourse network analysis of UK newspaper coverage.

BACKGROUND AND AIMS: Minimum unit pricing (MUP) for alcohol was introduced in Scotland on 1 May 2018, and is now on the policy agenda in other devolved administrations and at Westminster. Previous research has explored the arguments deployed for and against MUP, but the congruence between actors in the MUP debate has not been sufficiently examined. This study identified and mapped the discourse coalitions that emerged in the UK MUP debate through an analysis of actors' use of arguments in media coverage of the policy debates. DESIGN: A sample of print media coverage of MUP was obtained from the LexisNexis newspaper database. The resulting sample was imported into discourse network analysis (DNA) software for coding and subsequent visualization of actor networks. SETTING: United Kingdom. OBSERVATIONS: A total of 348 articles from eight UK-wide and three Scottish newspapers from an 18-month period, ending in November 2012, were analysed. MEASUREMENTS: Actors' arguments were coded to generate structured data for conversion into a weighted actor network where ties represent similarities among actors in terms of arguments in support of or opposition to MUP. FINDINGS: Two polarized discourse coalitions, Opponents and Proponents of MUP, emerged in media coverage. The Proponents coalition consisted mainly of health advocacy groups, charities, political parties and academic institutions. In the Opponents coalition, the networks were formed of key alcohol manufacturers and economic think-tanks. While producer organizations were central to the Opponents coalition, some commercial actors were more favourable to MUP, highlighting divisions within the industry overall. CONCLUSIONS: Media coverage of minimum unit pricing (MUP) in Scotland from June 2011 to November 2012 showed alignment between the policy positions of (1) alcohol producers and think-tanks opposed to MUP; and (2) public health advocates and health charities in favour of the policy. Some alcohol industry actors were supportive of MUP indicating divisions among the industry. Discourse network analysis may be usefully applied to study other highly contested policy issues in health and beyond.

Agenda setting and framing of gender-based violence in Nepal: how it became a health issue.

Gender-based violence (GBV) has been addressed as a policy issue in Nepal since the mid 1990s, yet it was only in 2010 that Nepal developed a legal and policy framework to combat GBV. This article draws on the concepts of agenda setting and framing to analyse the historical processes by which GBV became legitimized as a health policy issue in Nepal and explored factors that facilitated and constrained the opening and closing of windows of opportunity. The results presented are based on a document analysis of the policy and regulatory framework around GBV in Nepal. A content analysis was undertaken. Agenda setting for GBV policies in Nepal evolved over many years and was characterized by the interplay of political context factors, actors and multiple frames. The way the issue was depicted at different times and by different actors played a key role in the delay in bringing health onto the policy agenda. Women's groups and less powerful Ministries developed gender equity and development frames, but it was only when the more powerful human rights frame was promoted by the country's new Constitution and the Office of the Prime Minister that legislation on GBV was achieved and a domestic violence bill was adopted, followed by a National Plan of Action. This eventually enabled the health frame to converge around the development of implementation policies that incorporated health service responses. Our explicit incorporation of framing within the Kindgon model has illustrated how important it is for understanding the emergence of policy issues, and the subsequent debates about their resolution. The framing of a policy problem by certain policy actors, affects the development of each of the three policy streams, and may facilitate or constrain their convergence. The concept of framing therefore lends an additional depth of understanding to the Kindgon agenda setting model.

Industry use of evidence to influence alcohol policy: a case study of submissions to the 2008 Scottish government consultation.

Jim McCambridge and colleagues analyze industry submissions to a Scottish Government consultation on whole-population approaches to alcohol policy.