摘要：Over the past 50 years, tobacco control has been transformed from a national to a global issue, becoming institutionalized in the World Health Organization (WHO) Framework Convention on Tobacco Control, the first international public health treaty negotiated under the auspices of the WHO. The global tobacco control epistemic community, a worldwide network of professionals with a common interpretation of the science in tobacco use and control, has contributed to this transformation. We investigated the development, structure, and function of this community through interviews and archival documents. Professionals in the community are bound by values and consensual knowledge developed after years of contentious debates undergirded their activities. Although these professionals play multiple roles, they recognize that scientific evidence should inform advocacy and policy activities. Public health professionals should continue to strengthen the links between science and advocacy for policy while being vigilant against industry efforts to undermine the scientific evidence on tobacco use and control. Global tobacco control changed incrementally but dramatically between the early 1960s and 2010. The number of countries with tobacco control policies increased from 30 in 1976 1 to 91 in 1996 2 and to almost all in 2009. 3 As of September 2011, there were 174 parties to the 2003 World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC), the first international public health treaty negotiated under the WHO. 4 The evolution of tobacco control from a national to international issue reflects the development and effectiveness of nonstate actors and the importance of the linkages between civil society and science. Previous research on global tobacco control focused on advocacy networks, 5 – 10 specific states, 11 , 12 and governmental organizations. 13 It is generally recognized that science influences policy in tobacco control. 14 , 15 Although some authors have noted the integral role of an epistemic community in the broader tobacco control community and global tobacco control policymaking process, 6 , 11 , 16 , 17 little is known about the epistemic community's characteristics. An epistemic community is a “network of professionals with recognized expertise and competence in a particular domain.” 18 (p3) It differs from social movements and advocacy networks by being characterized by consensual knowledge developed through scientific evidence, with the policy driven by science. 18 – 21 Epistemic communities often play important roles in influencing state policymaking behavior because they act as scientific gatekeepers in the policymaking process. This community is important because of the crucial role nonstate actors play in global tobacco control policymaking 8 , 11 and because tobacco companies view tobacco control advocates as having gained their policymaking influence through alliances with epistemic communities. 22 Because of the scientific gatekeeping role that epistemic communities play in the policymaking process, it is important that public health professionals continue to strengthen the links between science and advocacy for policy and to be vigilant against industry efforts to undermine the scientific basis of tobacco control policies and of the global tobacco control epistemic community itself.
