{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T07:03:21Z","timestamp":1779779001865,"version":"3.53.1"},"reference-count":53,"publisher":"BMJ","funder":[{"name":"Africa Capacity Building Foundation","award":["330"],"award-info":[{"award-number":["330"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Tob Control"],"accepted":{"date-parts":[[2026,5,14]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The tobacco industry (TI) is a globalised enterprise whose interference activities transcend national borders, undermining tobacco control policies and implementation of the WHO Framework Convention on Tobacco Control (WHO FCTC). Sub-Saharan Africa (SSA) has been a particular target for market expansion by the TI. While individual-country studies have documented policy interference activities in SSA, no comparative studies about the depth or scale exist. This study provides the first cross-country comparative analysis quantifying the frequency and distribution of TI interference activities in six SSA countries: Ethiopia, Kenya, Nigeria, Senegal, South Africa and Uganda.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Qualitative content analysis was conducted to compare and analyse information from reports of TI interference activities in the six countries. The frequency of TI interference activities in the reports was coded and mapped to six categories defined in the 2012 WHO document \u2018Tobacco Industry Interference: A Global Brief.\u2019<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 234 distinct TI interference events were identified. The most common tactics involved manipulating public opinion (40%) and hijacking political and legislative processes (28%), followed by use of front groups (14%) and litigation threats (9%). Although the frequency and distribution of these activities differed across the six countries, manipulating public opinion was the most common activity and discrediting proven science was the least common activity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Findings indicate the pervasive and evolving nature of TI interference in SSA and highlight the need for sustained regional collaboration to monitor activities, share data and strengthen enforcement of WHO FCTC Article 5.3. Further research is needed to understand different contexts.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/tc-2025-059690","type":"journal-article","created":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T06:20:12Z","timestamp":1779776412000},"page":"tc-2025-059690","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Tobacco industry interference activities: a comparative case study across six countries in Sub-Saharan Africa"],"prefix":"10.1136","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1530-7825","authenticated-orcid":false,"given":"Kate L","family":"Nolt","sequence":"first","affiliation":[{"name":"Public Health Advisor & Consultant Tobacco Control, Aston, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0098-9053","authenticated-orcid":false,"given":"Adeola Omolade","family":"Ayo","sequence":"additional","affiliation":[{"name":"Health Services Management and Policy, College of Public Health, East Tennessee State, Johnson City, Tennessee, USA"},{"name":"Center for Cardiovascular Risk Research, East Tennessee State University, Johnson City, Tennessee, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3304-5577","authenticated-orcid":false,"given":"Hadii M","family":"Mamudu","sequence":"additional","affiliation":[{"name":"Health Services Management and Policy, College of Public Health, East Tennessee State, Johnson City, Tennessee, USA"},{"name":"Center for Cardiovascular Risk Research, East Tennessee State University, Johnson City, Tennessee, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5698-6866","authenticated-orcid":false,"given":"Catherine O","family":"Egbe","sequence":"additional","affiliation":[{"name":"Mental Health, Alcohol, Substance Use & Tobacco Research Unit, South African Medical Research Council, Pretoria, South Africa"},{"name":"Department of Public Health, Sefako Makgatho Health Sciences University, Pretoria, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4939-056X","authenticated-orcid":false,"given":"Lungile","family":"Nkosi","sequence":"additional","affiliation":[{"name":"Africa Centre for Tobacco Industry Monitoring and Policy Research (ATIM), School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-1357-4176","authenticated-orcid":false,"given":"Kgomotso Sarah","family":"Kali","sequence":"additional","affiliation":[{"name":"Africa Centre for Tobacco Industry Monitoring and Policy Research (ATIM), School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6471-5457","authenticated-orcid":false,"given":"Stella","family":"Bialous","sequence":"additional","affiliation":[{"name":"Shool of Nursing and Center for Tobacco Control Research and Education, University of California, San Francisco, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0689-7018","authenticated-orcid":false,"given":"Olalekan A","family":"Ayo-Yusuf","sequence":"additional","affiliation":[{"name":"Africa Center for Tobacco Industry Monitoring and Policy Research (ATIM), University of Pretoria School of Health Systems and Public Health, Pretoria, South Africa"},{"name":"Directorate for Research and Postgradute Studies, Safako Makgatho Health Sciences University, Pretoria, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,5,25]]},"reference":[{"key":"2026052523200634000_tc-2025-059690v1.1","unstructured":"WHO . 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