Banning shisha smoking in public places in Iran: an advocacy coalition framework perspective on policy process and change

Abstract : Introduction - Shisha smoking is a widespread custom in Iran with a rapidly growing prevalence especially among the youth. In this article, we analyze the policy process of enforcing a federal/state ban on shisha smoking in all public places in Kerman Province, Iran. Guided by the Advocacy Coalition Framework (ACF), we investigate how a shisha smoking ban reached the political agenda in 2011, how it was framed by different policy actors, and why no significant breakthrough took place despite its inclusion on the agenda. Methods - We conducted a qualitative study using a case study approach. Two main sources of data were employed: face-to-face in-depth interviews and document analysis of key policy texts. We interviewed 24 policy actors from diverse sectors. A qualitative thematic framework, incorporating both inductive and deductive analyses, was employed to analyze our data. Results - We found that the health sector was the main actor pushing the issue of shisha smoking onto the political agenda by framing it as a public health risk. The health sector and its allies advocated enforcement of a federal law to ban shisha smoking in all public places including teahouses and traditional restaurants whereas another group of actors opposed the ban. The pro-ban group was unable to neutralize the strategies of the anti-ban group and to steer the debate towards the health harms of shisha smoking. Our analysis uncovers three main reasons behind the policy stasis: lack of policy learning due to lack of agreement over evidence and related analytical conflicts between the two groups linked to differences in core and policy beliefs; the inability of the pro-ban group to exploit opportunities in the external policy subsystem through generating stronger public support for enforcement of the shisha smoking ban; and the nature of the institutional setting, in particular the autocratic governance of CHFS which contributed to a lack of policy learning within the policy subsystem. Conclusions - Our research demonstrated the utility of ACF as a theoretical framework for analyzing the policy process and policy change to promote tobacco control. It shows the importance of accounting for policy actors' belief systems and issue-framing in understanding how some issues get more prominence in the policy-making process than others. Our findings further indicate a need for significant resources employed by the state through public awareness campaigns to change public perceptions of shisha smoking in Iran which is a deeply anchored cultural practice.
Type de document :
Article dans une revue
Health Policy and Planning, Oxford University Press (OUP), 2017, 32 (6), pp.835-846. 〈10.1093/heapol/czx015〉
Liste complète des métadonnées

Littérature citée [69 références]  Voir  Masquer  Télécharger

https://hal-univ-rennes1.archives-ouvertes.fr/hal-01586046
Contributeur : Laurent Jonchère <>
Soumis le : mercredi 16 mai 2018 - 10:06:06
Dernière modification le : jeudi 17 mai 2018 - 01:03:49
Document(s) archivé(s) le : lundi 24 septembre 2018 - 16:08:30

Fichier

Banning shisha smoking in publ...
Fichiers produits par l'(les) auteur(s)

Identifiants

Citation

Akram Khayatzadeh-Mahani, Eric Breton, Arne Ruckert, Ronald Labonte. Banning shisha smoking in public places in Iran: an advocacy coalition framework perspective on policy process and change. Health Policy and Planning, Oxford University Press (OUP), 2017, 32 (6), pp.835-846. 〈10.1093/heapol/czx015〉. 〈hal-01586046〉

Partager

Métriques

Consultations de la notice

108

Téléchargements de fichiers

39