The Perfect Storm: Applying the Multiple Streams Framework to Understand the Adoption of a WHO Framework Convention on Tobacco Control-Based Policy in Mexico
2024
Eric Crosbie | Sara Perez | Adriana Rocha Camarena | Valentina Ochoa Vivanco | Gianella Severini | Patricia Gutkowski | Patricia Sosa | Ernesto M. Sebrié
Background: The aim of this study was to document how Mexico adopted a WHO Framework Convention on Tobacco Control (FCTC)-based national tobacco control law. Methods: We analyzed publicly available documents and interviewed 14 key stakeholders. We applied the Multiple Streams Framework (MSF) to analyze these findings. Results: Previous attempts to approve comprehensive FCTC-based initiatives failed due to a lack of political will, the tobacco industry&rsquo:s close connections to policymakers, and a lack of health advocacy coordination. Applying the MSF reveals increased attention towards collecting and sharing data to frame the severity of the problem (problem stream). The expansion of a coordinated health advocacy coalition and activities led to increased support for desired FCTC policy solutions (policy stream). The election of President Ló:pez Obrador and legislative changes led to a deep renewed focus on tobacco control (politics stream). These three streams converged to create a policy window to secure a strong FCTC-based initiative on the political agenda that was ultimately passed. Conclusions: The Mexican experience illustrates the importance of continued health advocacy and political will in adopting FCTC-based policies. Other countries should follow Mexico&rsquo:s lead by collecting and sharing data through coordinating efforts in order to be prepared to seize political opportunity windows when strong political will is present.
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