The influence of public opinion on tobacco control policy-making in Georgia: Perspectives of governmental and non-governmental stakeholders

Introduction: Georgia has one of the highest smoking rates (36%) in Europe. This may be due partly to the fact that the present Georgian tobacco control regulations are weakly enforced. It is unclear if the authorities are aware that they would have majority public support for tighter enforcement of tobacco control regulations. The study aimed to fill a knowledge gap by addressing these research questions: (1) To what degree are policy makers aware of the Georgian public’s opinions about tobacco control and enforcement? (2) To what degree do policy makers take Georgian public opinion into account in their decision-making, including tobacco control and enforcement? Methods: This study used a collective case study methodology. The data were obtained through 12 semi-structured interviews during the period from April to May 2013, with three respondents each from the Ministry of Health, the Parliament of Georgia, Opinion Research Agencies and Non-Governmental Organizations. Thematic Network Analysis was used to analyze the interview data. Results: Policy-makers are aware that public opinion favors tobacco control and enforcement. However, Georgian politicians don’t take public opinion into account during policy-making. Tobacco industry influence is very strong in the Georgian policy-making arena. Some policy-makers are themselves lobbyists for the tobacco industry, and ignore public opinion. Public health planning and strategy development occur without public involvement. Conclusions: Georgia faces a challenge in increasing the influence of public opinion in health policy making generally, and in tobacco control in particular