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Phetphum C, Wangwonsin A, Prajongjeep A, Simsin S. Perspectives of push-pull-mooring effects on a desire for switching to alternative crops among tobacco farmers in Thailand: A qualitative study. Tob Induc Dis 2024; 22:TID-22-07. [PMID: 38204731 PMCID: PMC10777475 DOI: 10.18332/tid/175685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 11/10/2023] [Accepted: 11/22/2023] [Indexed: 01/12/2024] Open
Abstract
INTRODUCTION Tobacco use contributes significantly to premature deaths worldwide. A key strategy to curb tobacco consumption involves limiting the tobacco supply through the transition to substitute crops. This study aims to provide insight into why tobacco farmers desire to switch to alternative crops and the support required for a successful transition. METHODS Semi-structured interviews were conducted with 34 tobacco farmers expressing a desire to transition to other crops in two communities in Thailand. Data were recorded and transcribed verbatim in Thai and subsequently translated into English. A deductive content analysis applied the Push-Pull-Mooring (PPM) framework, contextualizing factors for the transition among tobacco farmers. RESULTS Four main categories emerged: 1) push factors, encompassing negative experiences in growing tobacco, such as poverty, health problems, and hopelessness; 2) pull factors, representing positive experiences in transitioning to alternative crops, particularly having a role model; and 3) mooring factors, highlighting characteristic disadvantages of tobacco farmers, particularly the receipt of small tobacco growing quotas. The fourth category focused on the support needed for a successful transition, including the suspension of tobacco debt payments, access to low-interest loans, and the development of marketing capabilities. CONCLUSIONS The study provides a comprehensive understanding of farmers' motivations to switch from tobacco to alternative crops and outlines the necessary support for a successful transition. Offering financial assistance and enhancing the production and marketing capabilities of alternative crops are essential steps toward facilitating a successful switch for farmers and ensuring a secure livelihood beyond tobacco farming.
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Affiliation(s)
- Chakkraphan Phetphum
- Department of Community Health, Faculty of Public Health, Naresuan University, Phitsanulok, Thailand
- Tobacco Control Research Unit, Naresuan University, Phitsanulok, Thailand
| | - Artittaya Wangwonsin
- Department of Community Health, Faculty of Public Health, Naresuan University, Phitsanulok, Thailand
| | - Atchara Prajongjeep
- Department of Community Public Health, Sirindhorn College of Public Health, Phitsanulok, Thailand
| | - Saksin Simsin
- Department of Community Health, Faculty of Public Health, Naresuan University, Phitsanulok, Thailand
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Phetphum C, Prajongjeep A, Keeratisiroj O, Simsin S, Thawatchaijareonying K. Deteriorating Quality of Life and a Desire to Stop Growing Tobacco Among Virginia and Burley Tobacco Farmers in Thailand. JCO Glob Oncol 2022; 8:e2200180. [PMID: 36049151 PMCID: PMC9470139 DOI: 10.1200/go.22.00180] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
This study aimed to examine the quality of life of tobacco farmers and their desire to stop growing tobacco. Most tobacco farmers in Thailand have a declining quality of life resulting in reducing growing tobacco.
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Affiliation(s)
- Chakkraphan Phetphum
- Department of Community Health, Faculty of Public Health, Naresuan University, Phitsanulok, Thailand
- Tobacco Control Research Unit (Northern Region), Naresuan University, Phitsanulok, Thailand
| | - Atchara Prajongjeep
- Department of Community Public Health, Sirindhorn College of Public Health, Phitsanulok, Thailand
| | - Orawan Keeratisiroj
- Department of Community Health, Faculty of Public Health, Naresuan University, Phitsanulok, Thailand
| | - Saksin Simsin
- Department of Community Health, Faculty of Public Health, Naresuan University, Phitsanulok, Thailand
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Rao Seshadri S, Kaulgud R, Jha P. 'You cannot touch taxes easily': making the case for tobacco taxation in India. Health Policy Plan 2021; 36:322-331. [PMID: 33367775 DOI: 10.1093/heapol/czaa171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/17/2020] [Indexed: 11/12/2022] Open
Abstract
India represents over 1.3 billion people with >100 million adult smokers. The catastrophic health costs of smoking are staggering; and estimates show that even modest increases in taxes on cigarettes and bidis would both raise substantial revenues for the government and save ∼69 million years of healthy life over the next four decades. Karnataka represents a good example of tobacco control efforts and their impact. This case study examines the factors that have contributed to tobacco control policy in Karnataka based on 23 semi-structured interviews with key informants engaged in tobacco policymaking and decision-making, tobacco control/taxation research and advocacy. Their narratives indicate that: (i) Domestic taxation policy is complicated by the complex tax structure and centralized control over taxation with the introduction of Goods and Services Tax; (ii) Implementation of legal frameworks is a challenge, due to conflicts with powerful industry and farmer lobbies. A vigorous civil society backed by the Courts is necessary to garner political support; (iii) Action on taxation is hampered by weak leadership and mixed messaging; and (iv) There is a need for innovative policy solutions to promote both demand- and supply-side measures for tobacco control. Tobacco control advocates need to recognize the political economy of tobacco control and generate strong, reliable and scientifically sound evidence to support their arguments. Working for incremental 'wins' in terms of more stringent application of existing legal frameworks can make a substantial difference even in contexts where enhancing tobacco taxes is a challenge. Promoting multisectoral action is critical, at both policy and the ground levels, by expanding ownership and responsibility for tobacco control to sectors beyond health. Finally, the health sector needs to recommit to its role as a champion for tobacco control. Failure to do so would amount to a failure on multiple fronts-public health, economic, fiscal and ethical.
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Affiliation(s)
- Shreelata Rao Seshadri
- Azim Premji University, School of Development, Bikkanahalli Main Road, Sarjapura, Bangalore 562125, India
| | - Radhika Kaulgud
- Azim Premji University, School of Development, Bikkanahalli Main Road, Sarjapura, Bangalore 562125, India
- SOCHARA, Ist Block Koramangala, Bangalore 560034, India
| | - Prabhat Jha
- Center for Global Health Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital, 30 Bond Street, Toronto, Ontario M5B 1W8, Canada
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Sahadewo GA, Drope J, Li Q, Witoelar F, Lencucha R. In-and-Out of Tobacco Farming: Shifting Behavior of Tobacco Farmers in Indonesia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E9416. [PMID: 33334032 PMCID: PMC7765560 DOI: 10.3390/ijerph17249416] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 12/07/2020] [Accepted: 12/09/2020] [Indexed: 01/01/2023]
Abstract
Understanding the variables that affect farmers' decisions as to whether to grow tobacco and/or other crops provides important insights into their economic lives and can help to inform the development and implementation of policies that shape both tobacco production and tobacco control, such as increasing tobacco excise taxes. This study employs complementary quantitative and qualitative methodologies to identify variables that affect tobacco farmers' economic decision making in Indonesia, a major tobacco producer. The research focuses on the variables that affect tobacco farmers' decisions to continue tobacco farming or shift to non-tobacco farming. It finds that tobacco farmers' decision making is complex but also predictable. The results of the quantitative analysis suggest that farming profits and positive rainfall shocks are two of the key variables that affect the decision to cultivate tobacco. The qualitative results confirm these findings and further illuminate that access to credit, education (agricultural and otherwise) and information play substantial roles in farmers' economic decision making. Most of these variables are affected by the unequal relationship between the tobacco firms that buy tobacco and the farmers, wherein the farmers are consistently at a disadvantage in terms of negotiating key parameters such as prices and evaluation of leaf quality.
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Affiliation(s)
| | - Jeffrey Drope
- Health Policy and Administration, School of Public Health, University of Illinois at Chicago (UIC), Chicago, IL 60608, USA
| | - Qing Li
- Economic & Health Policy Research, Data Science, American Cancer Society, Atlanta, GA 30303, USA;
| | - Firman Witoelar
- Crawford School of Public Policy, Australian National University, Canberra 2600, ACT, Australia;
| | - Raphael Lencucha
- Faculty of Medicine, School of Physical and Occupational Therapy, McGill University, Montreal, QC 3605, Canada;
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Appau A, Drope J, Goma F, Magati P, Labonte R, Makoka D, Zulu R, Li Q, Lencucha R. Explaining Why Farmers Grow Tobacco: Evidence From Malawi, Kenya, and Zambia. Nicotine Tob Res 2020; 22:2238-2245. [PMID: 31608412 PMCID: PMC7733062 DOI: 10.1093/ntr/ntz173] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Accepted: 09/04/2019] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Tobacco production continues to increase in low- and middle-income countries creating complications for tobacco control efforts. There is the need to understand and address the global tobacco leaf supply as a means of decreasing tobacco consumption and improving farmers livelihoods in line with Article 17 of the WHO Framework Convention on Tobacco Control. This study aims to understand the reasons why farmers grow tobacco and identify factors that influence these reasons. METHODS Primary survey data (N = 1770) collected in Kenya, Malawi, and Zambia in the 2013-2014 farming season. Data analysis uses both descriptive and multinomial logistical regression methods. RESULTS Majority of farmers started and are currently growing tobacco because they believed it was the only economically viable crop. Compared with Malawi, farmers in Kenya and Zambia have a 0.2 and 0.4 lower probability of growing tobacco, respectively because they perceive it as the only economically viable crop, but a 0.04 and 0.2 higher probability of growing tobacco, respectively because they believe it is highly lucrative. There are district/county differences in the reasons provided with some districts having a majority of the farmers citing the existence of a ready market or incentives from the tobacco industry. Statistically significant factors influencing these reasons are the educational level and age of the household head, land allocated to tobacco and debts. CONCLUSION There is the need to address the unique features of each district to increase successful uptake of alternative livelihoods. One consistent finding is that farmers' perceived economic viability contributes to tobacco growing. IMPLICATIONS This study finds that perceived economic viability of tobacco is the dominant factor in the decisions to grow tobacco by smallholder farmers in Malawi, Kenya, and Zambia. There is the need to more deeply understand what contributes to farmers' perceived viability of a crop. Understanding and addressing these factors may increase the successful uptake of alternative livelihoods to tobacco. Furthermore, this study demonstrates that a one-size fits all alternative livelihood intervention is less likely to be effective as each district has unique features affecting farmers' decisions on growing tobacco.
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Affiliation(s)
- Adriana Appau
- Faculty of Medicine, School of Physical and Occupational Therapy, McGill University, Montreal, Canada
| | - Jeffrey Drope
- Economic and Health Policy Research, American Cancer Society, Atlanta, GA
| | - Fastone Goma
- School of Medicine, University of Zambia, Lusaka, Zambia
| | - Peter Magati
- Economic and Health Policy Research, American Cancer Society, Atlanta, GA
- African Population and Health Research Center, Nairobi, Kenya
| | - Ronald Labonte
- Institute of Population Health, University of Ottawa, Ottawa, Canada
| | - Donald Makoka
- Centre for Agricultural Research and Development, Lilongwe, Malawi
| | - Richard Zulu
- School of Medicine, University of Zambia, Lusaka, Zambia
| | - Qing Li
- Economic and Health Policy Research, American Cancer Society, Atlanta, GA
| | - Raphael Lencucha
- Faculty of Medicine, School of Physical and Occupational Therapy, McGill University, Montreal, Canada
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Clark M, Magati P, Drope J, Labonte R, Lencucha R. Understanding Alternatives to Tobacco Production in Kenya: A Qualitative Analysis at the Sub-National Level. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E2033. [PMID: 32204418 PMCID: PMC7143228 DOI: 10.3390/ijerph17062033] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Revised: 03/13/2020] [Accepted: 03/16/2020] [Indexed: 01/22/2023]
Abstract
Tobacco is a key cash crop for many farmers in Kenya, although there is a variety of challenges associated with tobacco production. This study seeks to understand alternatives to tobacco production from the perspective of government officials, extension officers, and farmers at the sub-national level (Migori, Busia, and Meru) in Kenya. The study analyzes data from qualitative key-informant interviews with government officials and extension officers (n = 9) and focus group discussions (FGDs) with farmers (n = 5). Data were coded according to pre-identified categories derived from the research aim, namely, opportunities and challenges of tobacco farming and alternative crops, as well findings that illustrate the policy environment that shapes the agricultural context in these regions. We highlight important factors associated with the production of non-tobacco agricultural commodities, including the factors that shape the ability of these non-agricultural commodities to serve as viable alternatives to tobacco. The results highlight the effect that several factors, including access to capital, markets, and governmental assistance, have on farmer decisions. The results additionally display the structured policy approaches that are being promoted in governmental offices towards agricultural production, as well as the institutional shortcomings that inhibit their implementation at the sub-national level.
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Affiliation(s)
- Madelyn Clark
- Faculty of Medicine, School of Physical and Occupational Therapy, McGill University, 3630 Promenade Sir William Osler, Montreal, QC H3G 1Y5, Canada;
| | - Peter Magati
- School of Economics, University of Nairobi, Nairobi 30197, Kenya;
| | - Jeffrey Drope
- Economic and Health Policy Research, American Cancer Society, Atlanta, GA 30303, USA;
| | - Ronald Labonte
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON K1N 6N5, Canada;
| | - Raphael Lencucha
- Faculty of Medicine, School of Physical and Occupational Therapy, McGill University, 3630 Promenade Sir William Osler, Montreal, QC H3G 1Y5, Canada;
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Lencucha R, Pal NE, Appau A, Thow AM, Drope J. Government policy and agricultural production: a scoping review to inform research and policy on healthy agricultural commodities. Global Health 2020; 16:11. [PMID: 31959213 PMCID: PMC6971899 DOI: 10.1186/s12992-020-0542-2] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 01/13/2020] [Indexed: 12/20/2022] Open
Abstract
Unhealthy foods and tobacco remain the leading causes of non-communicable disease (NCDs). These are key agricultural commodities for many countries, and NCD prevention policy needs to consider how to influence production towards healthier options. There has been little scholarship to bridge the agriculture with the public health literature that seeks to address the supply of healthy commodities. This scoping review synthesizes the literature on government agricultural policy and production in order to 1) present a typology of policies used to influence agricultural production, 2) to provide a preliminary overview of the ways that impact is assessed in this literature, and 3) to bring this literature into conversation with the literature on food and tobacco supply.This review analyzes the literature on government agricultural policy and production. Articles written in English and published between January 1997 and April 2018 (20-year range) were included. Only quantitative evaluations were included. Studies that collected qualitative data to supplement the quantitative analysis were also included. One hundred and three articles were included for data extraction. The following information was extracted: article details (e.g., author, title, journal), policy details (e.g., policy tools, goals, context), methods used to evaluate the policy (e.g., outcomes evaluated, sample size, limitations), and study findings. Fifty four studies examined the impact of policy on agricultural production. The remaining articles assessed land allocation (n = 25) (e.g., crop diversification, acreage expansion), efficiency (n = 23), rates of employment including on- and off-farm employment (n = 18), and farm income (n = 17) among others. Input supports, output supports and technical support had an impact on production, income and other outcomes. Although there were important exceptions, largely attributed to farm level allocation of labour or resources. Financial supports were most commonly evaluated including cash subsidies, credit, and tax benefits. This type of support resulted in an equal number of studies reporting increased production as those with no effects.This review provides initial extrapolative insights from the general literature on the impact of government policies on agricultural production. This review can inform dialogue between the health and agricultural sector and evaluative research on policy for alternatives to tobacco production and unhealthy food supply.
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Affiliation(s)
- Raphael Lencucha
- School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, 3630 Promenade Sir William Osler, Montreal, QC, H3G 1Y5, Canada.
| | - Nicole E Pal
- Faculty of Sciences, Vrije Universiteit, Amsterdam, Netherlands
| | - Adriana Appau
- Research and Evaluation, PolicyWise for Children and Families, Edmonton, Alberta, Canada
| | - Anne-Marie Thow
- Menzies Centre for Health Policy, School of Public Health, University of Sydney, Sydney, Australia
| | - Jeffrey Drope
- Economic and Health Policy Research, American Cancer Society, Atlanta, USA
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Appau A, Drope J, Witoelar F, Chavez JJ, Lencucha R. Why Do Farmers Grow Tobacco? A Qualitative Exploration of Farmers Perspectives in Indonesia and Philippines. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E2330. [PMID: 31269640 PMCID: PMC6651112 DOI: 10.3390/ijerph16132330] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 06/21/2019] [Accepted: 06/27/2019] [Indexed: 11/21/2022]
Abstract
Tobacco supply remains a pressing challenge to tobacco control. Tobacco remains a dominant cash crop in many low- and middle-income countries, despite the evidence suggesting that it is not as profitable as industry claims and is harmful to health and the environment. In order to implement successful and sustainable alternative livelihood interventions, it is important to understand why farmers continue to grow tobacco. This study explores this question from the perspective of farmers in Indonesia and Philippines. This study was informed by interpretive description methodology. Data was collected through focus group discussions (FGDs) (n = 7) with farmers (n = ~60). The FGDs were audio recorded, transcribed verbatim, and then translated into English. An inductive thematic analysis of the data was conducted to identify and categorize the reason provided by participants. We identified two overarching themes: (1) perceived viability (profitability, ready market, and environmental factors) and (2) financial context. Financial context included lumpsum payments and access to financial loans and credit facilities in light of their lack of capital. These results highlight that, in addition to identifying viable alternatives to tobacco, institutional factors such as improved access to credit and well-developed supply chains are key to the successful uptake of alternative livelihoods.
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Affiliation(s)
- Adriana Appau
- Faculty of Medicine, School of Physical and Occupational Therapy, McGill University, 3630 Promenade Sir William Osler, Montreal, QC H3G 1Y5, Canada.
| | - Jeffrey Drope
- Economic and Health Policy Research, American Cancer Society, Atlanta, GA 30303, USA
| | - Firman Witoelar
- Crawford School of Public Policy, Australian National University, Canberra, ACT 2601, Australia
| | - Jenina Joy Chavez
- Action for Economic Reform, Unit 1403 West Trade Center, 132 West Avenue, Quezon City 1104, Philippines
| | - Raphael Lencucha
- Faculty of Medicine, School of Physical and Occupational Therapy, McGill University, 3630 Promenade Sir William Osler, Montreal, QC H3G 1Y5, Canada
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