The 13th World Conference on Tobacco OR Health

Objective: The objective is to use Actor Network Theory (ANT) to better understand (and hence respond to) the tensions emerging within the Tobacco Control Coalition about product and regulatory initiatives designed to reduce the harms associated with the use of nicotine – an area where there is substantial disagreement within the coalition, and a lack of scientific consensus.

Methods: ANT describes how complex networks, between heterogeneous “actants” (researchers, practitioners, institutions, politicians, laws, protocols, research findings etc.) are forged, mobilised and maintained to achieve some goal. As such, it is extremely useful for enhancing the capability of coalitions, institutions and other groups pursuing public health goals. The method employs interviews, questionnaires and analysis of secondary data to identify the actants and the nature of their interactions.

Results: Early analysis indicates that actants in the Tobacco Control coalition have one of two broad goals: harm minimisation or risk avoidance. The goals have different conceptual underpinnings and, most importantly, quite different implications for how to deal with the new and emerging challenges facing the coalition. For various reasons, until recently, activities in tobacco control have rarely engaged with this difference, allowing it to be avoided. The increasing focus on both “harm minimisation” and “product regulation” threatens to “un-mix” (like oil and water) the goals, and in doing so has the potential to escalate tension and conflict within the coalition to the point where it may split. Understanding the dynamics may help us to avoid such a split.