Tobacco industry success in Costa Rica: the importance of FCTC article 5.3.

OBJECTIVE To analyze how the tobacco industry influenced tobacco control policymaking in Costa Rica. MATERIALS AND METHODS Review of tobacco industry documents, tobacco control legislation, newspaper articles, and interviewing of key informants. RESULTS During the mid-to-late 1980s, Health Ministry issued several advanced (for their time) smoking restriction decrees causing British American Tobacco (BAT) and Philip Morris International (PMI) to strengthen their political presence there, resulting in passage of a weak 1995 law, which, as of August 2011, remained in effect. Since 1995 the industry has used Costa Rica as a pilot site for Latin American programs and has dominated policymaking by influencing the Health Ministry, including direct private negotiations with the tobacco industry which violate Article 5.3's implementing guidelines of the World Health Organization Framework Convention on Tobacco Control (WHO FCTC). CONCLUSIONS The Costa Rica experience demonstrates the importance of vigorous implementation of FCTC Article 5.3 which insulates public health policymaking from industry interference.