Grant: Project Grant

Tobacco use remains a leading cause of non-communicable diseases, creates an enormous burden on health care systems, and imperils the quality of life of users and their families. Low- and middle-income countries (LMICs) growing tobacco often pursue tobacco production as an economic development strategy, creating challenges to the tobacco control efforts of health ministries'. This development strategy assumes that tobacco production is beneficial to farmers' livelihoods and to the country's overall economy. There is little empirical research supporting this assumption and, to the contrary, our research demonstrates that tobacco farmers generally experience precarious economic livelihoods. Policy makers are often unaware of the economic circumstances of tobacco farmers, the costs of tobacco growing, and experience numerous pressures from industry and other actors to support tobacco growing. We seek to extend our current research in four countries (Kenya, Zambia, Malawi and Indonesia) to Mozambique and Zimbabwe. Mozambique and Zimbabwe are experiencing steady increases in tobacco consumption and production. Though the WHO Framework Convention on Tobacco Control (FCTC) compels parties to find alternative livelihoods for smallholder tobacco growers, both countries have experienced substantial increases in smallholder tobacco production. In tandem with our other (already funded) studies, we will examine the factors that led to this increase in tobacco production, while inquiring into the livelihood conditions of tobacco farmers. We will also analyze the barriers and opportunities to stronger tobacco control policy in the two countries (both demand- and supply-side). Our results will better inform policy, programs and strategies to strengthen the control of tobacco supply and demand. Our research will inform tobacco control measures that are compatible with both health and economic development including economically viable alternatives to tobacco growing.