Exploration of Policy Makers’ Views on the Implementation of the Framework Convention on Tobacco Control in the Gambia: A Qualitative Study

Background: The World Health Organization’s Framework Convention on Tobacco Control (WHO FCTC) is the first international health treaty and has now been ratified by 181 countries. However, there are concerns that in many countries, particularly in Sub-Saharan African countries, FCTC legislations and implementation are weak. In this study we report a qualitative study undertaken to assess policy makers’ awareness of the FCTC and national tobacco control policies, and assessed the achievements and challenges to the implementation of the FCTC in The Gambia. Methods: The study involved semi-structured one-to-one interviews with 28 members of the National Tobacco Control Committee in The Gambia, which is responsible for formulating tobacco control policies and making recommendations for tobacco control. We used the Framework method and NVivo11 software for data analysis. Results: Our findings demonstrate that The Gambia has made modest progress in tobacco control before and since ratification of the FCTC, particularly in the areas of policy formulation, bans on tobacco advertising and promotion, smoke free laws and tobacco taxation. Whilst several pieces of tobacco control legislation exist, enforcement and implementation remain a major challenge. We found that policy makers’ awareness of polices covered in the FCTC was limited. Conclusion: Our findings highlight several challenges to the FCTC implementation and the need to step up efforts that will help to accomplish the obligations of the FCTC. To achieve the obligations of the FCTC, The Gambia should develop specific public awareness interventions, establish cessation services, mobilise adequate resources for tobacco control and strengthen tobacco surveillance and research