Chile’s Tobacco Strategy: A Scoping Review of Tobacco Measures Over Time

Abstract

Chile currently has a relatively robust tobacco control policy approach. Nonetheless, it has one of the highest tobacco consumption prevalence rates among adults worldwide. Better knowledge regarding changes in tobacco control policy over time may provide a comprehensive understanding of the observed changes in the prevalence of tobacco consumption. We aimed to carry out a scoping review to explore the evolution of Chile’s tobacco control consumption policies. We searched legal instruments, including laws and decrees, in the Chilean National Library of Congress from inception to December 2018. One author screened potential legal instruments; two authors independently systematized research records found. We included any legal instrument issued by the President of the Republic or the Chilean National Congress. We used the MPOWER strategy as a guideline to classify interventions. The institutional change theory proposed by van der Heijden and Kuhlmann was applied to interpret policy changes. We identified 499 legal instruments related to tobacco. Of these, three laws and ten decrees were included for analysis. We observed an uneven implementation of measures recommended by the WHO over time. The dimensions Protect, Warn, and Enforce showed consistent progress, measures in the Monitor and Raise dimensions were unsustained, and no measures for the dimension Offer were found. In Chile, measures to tackle tobacco consumption over the last three decades have focused predominantly on regulating individual choices rather than on the tobacco industry. Future research assessing the effects of Chile’s tobacco control consumption policies should account for their multifaceted and heterogeneous implementation.