Tobacco control in complex emergencies: Policy case study of Ukraine.

This policy case study evaluates Ukraine's implementation of tobacco control measures, using guidance from the World Health Organization Framework Convention on Tobacco Control (WHO FCTC) and its COP8 decision during the ongoing Russian invasion. The study assesses Ukraine's efforts across three pillars: 1) surveillance, 2) legislation and public health gains, and 3) adherence to the WHO FCTC Article 5.3. Despite war-related disruptions and a humanitarian crisis, Ukraine has upheld and strengthened policies like tobacco taxation, new pictorial health warnings on cigarette packs, advertising bans, and smoking restrictions, largely due to strong policy leadership and international collaborations driven by the European Union integration. Successes and political leadership over the past decade have reinforced Ukraine's compliance with the WHO FCTC. However, continued threats from the tobacco industry, especially efforts to weaken legislation and obstruct enforcement of regulations on new and emerging nicotine and tobacco products, remain a serious concern. This analysis underscores the vital role of a resilient public health infrastructure and sustained international support in protecting tobacco control progress, particularly during times of crisis.