ArticleHealth policy and planning2025
A realist evaluation of the implementation of a national tobacco control programme and policy in India.
Article in Health policy and planning, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Finding the Right Balance: Challenges in Optimising the Promise of Complexity Research for NCD Best-Buys Implementation and Adoption Comment on "Barriers and Opportunities for WHO 'Best Buys' Non-communicable Disease Policy Adoption and Implementation From a Political Economy Perspective: A Complexity Systematic Review".International journal of health policy and management · 2025Pooled it
- How to do (or not to do) realist evaluations to advance theory, practice, and justice in health systems research.Health policy and planning · 2026Article
- Implementing the World Health Organization - Framework Convention on Tobacco Control Article 5.3: A qualitative study in 17 Indian states.PLOS global public health · 2026Article
- Bridging the Divide in India's Tobacco Epidemic: A Review of the Effectiveness of Four Core Policy Interventions.International journal of dentistry · 2026Review
- Current scenario, challenges and way forward for augmenting tobacco control policies and programs in India: a community-based qualitative study.Global health action · 2025Article
- Identifying how tobacco industry-targeted communities perceive California's tobacco endgame initiative.Substance abuse treatment, prevention, and policy · 2025Article
- Unveiling tobacco struggle in rural areas: field insights and experiences from Rajasthan, India.Frontiers in public health · 2025Article
- A realist perspective on optimizing community health workers' roles and functions to deliver integrated people-centred care.PLOS global public health · 2025Article
- Breathing together: A global hashtag analysis of #LungHealth on platform X (formerly Twitter).Digital healthArticle
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
There is a growing interest in studying and unpacking the implementation of policies and programmes as it provides an opportunity to reduce the policy translation time lag taken for research findings to translate into policies and be implemented and to understand why policies may fail. Realist evaluation is a theory-driven approach that embraces complexity and helps to identify the mechanisms generating the observed policy outcomes in a given context. We aimed to study facilitators and barriers while implementing the Cigarettes and Other Tobacco Products Act 2003 (COTPA), a comprehensive national tobacco control policy, and the National Tobacco Control Programme 2008 (NTCP), using realist evaluation. We developed an initial programme theory (IPT) based on a realist literature review of tobacco control policies in low- and middle-income countries. Three diverse states-Kerala, West Bengal and Arunachal Pradesh-with varying degrees of implementation of tobacco control laws and programmes were chosen as case studies. Within the three selected states, we conducted in-depth interviews with 48 state and district-level stakeholders and undertook non-participant observations to refine the IPT. Following this, we organized two regional consultations covering stakeholders from 20 Indian states for a second iteration to further refine the programme theory. A total of 300 intervention-context-actor-mechanism-outcome configurations were developed from the interview data, which were later synthesized into state-specific narrative programme theories for Kerala, West Bengal and Arunachal Pradesh. We identified five mechanisms: collective action, felt accountability, individual motivation, fear and prioritization that were (or were not) triggered leading to diverse implementation outcomes. We identified facilitators and barriers to implementing the COTPA and the NTCP, which have important research and practical implications for furthering the implementation of these policies as well as implementation research in India. In the future, researchers could build on the refined programme theory proposed in this study to develop a middle-range theory to explain tobacco control policy implementation in India and other low- and middle-income countries.
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