Network influences on policy implementation: Evidence from a global health treaty

Soc Sci Med. 2019 Feb;222:188-197. doi: 10.1016/j.socscimed.2019.01.008. Epub 2019 Jan 9.


This paper examines whether country implementation of a public health treaty is influenced by the implementation behaviors of other countries to which they have network ties. We examine implementation of the Framework Convention on Tobacco Control (FCTC) adopted by the World Health Organization in 2003 and ratified by approximately 94% of countries as of 2016. We constructed five networks: (1) geographic distance, (2) general trade, (3) tobacco trade, (4) GLOBALink referrals, and (5) GLOBALink co-subscriptions. Network exposure terms were constructed from these networks based on the implementation scores for six articles of the FCTC treaty. We estimate effects using a lagged Type 1 Tobit model. Results show that network effects were significant: (a) across all networks for article 6 (pricing and taxation), (b) distance, general trade, GL referrals, and GL co-subscriptions for article 8 (second hand smoke), (c) distance, general trade, and GL co-subscriptions for article 11 (packaging and labeling), and (d) distance and GL co-subscription for article 13 (promotion and advertising), (e) tobacco trade and GL co-subscriptions for article 14 (cessation). These results indicate that diffusion effects were more prevalent for pricing and taxation as well as restrictions on smoking in public places and packaging and labeling. These results suggest that network influences are possible in domains that are amenable to control by national governments but unlikely to occur in domains established by existing regulatory systems. Implications for future studies of policy implementation are discussed.

Keywords: Diffusion of innovations; Policy implementation; Social network analysis; Tobacco control.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Communication
  • Costs and Cost Analysis
  • Global Health*
  • Government Programs / organization & administration
  • Guanosine Diphosphate
  • Health Policy*
  • Health Promotion / organization & administration*
  • Humans
  • International Cooperation
  • Politics
  • Product Packaging / legislation & jurisprudence
  • Product Packaging / methods
  • Public Health
  • Sex Factors
  • Smoking Prevention / organization & administration*
  • Spatial Analysis
  • Taxes / legislation & jurisprudence
  • Tobacco Products / economics
  • Tobacco Products / legislation & jurisprudence
  • Tobacco Smoke Pollution / prevention & control
  • World Health Organization


  • Tobacco Smoke Pollution
  • Guanosine Diphosphate