Strengthening Smoke-Free Policies in Tobacco-Farming Areas: Evidence from Qualitative Multiple-Case Study of LGU Implementation in Isabela, Philippines
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Abstract
Tobacco production remains a core sector of Isabela’s rural economy, but the public health effects make it harder to develop tobacco-free communities. Thus, the study concentrated on the status of implementation of Smoke-Free Environment (SFE) and Tobacco Control Policy (TCP), including policy adoption, enforcement mechanisms and improvement points for SFE in tobacco-farming communities in Isabela. Qualitative multiple-case design was conducted to key informant interview, focus group discussions alongside document reviews, and direct observations of sixty (60) policymakers, health officer and enforcement personnel. Validity and credibility were provided by thematic analysis as well as triangulation. The results showed that while compliance with both Republic Act No. 9211 and Executive Order No. 26 was observed among all local government units on which the ordinances are implemented, enforcement and sustainability varied greatly between municipalities. Municipality 3 was able to ensure compliance due to monitoring and leadership dynamics; operational challenges regarding resource limitations, weak coordination and acceptability of smoking are highlighted for Municipalities 1 and 2. Facilitators included political will, health education and inter-agency coordination while constraints included financial shortfalls and social tolerance for tobacco use. The study also suggests that smoke-free Isabela is likely to rely on enhanced enforcement measures, continued advocacy, and capacity building, particularly in accordance with the WHO Framework Convention on Tobacco Control (FCTC) and in the direction of SDG Goal 3 regarding good health and well-being which are the top recommendations. Developing funds specifically for smoke-free activities, enforcement methods, posting of smoke-free signage, training and enhancing policies help to achieve a Smoke-Free Environment that is safe for all.