Published in PLOS One on 2026-07-31, this study is presented as an attributed evidence briefing. The excerpts below are the original researchers’ words, reproduced under their Creative Commons Attribution licence. Health Signal has selected the abstract and, where needed, opening background paragraphs; the complete methods, results, limitations and references remain in the linked paper.
Original authors: Selamawit Hirpa, Noreen Dadirai Mdege, Terefe Gelibo Argefa, Selam Abraham Kassa, Wakgari Deressa
Source: PLOS One • DOI 10.1371/journal.pone.0354842
Read the complete primary study ↗ · Creative Commons Attribution licence
From the researchers
Abstract
Tobacco advertising and promotion remain major drivers of tobacco use, particularly at points of sale (PoS). Ethiopia has enacted comprehensive tobacco control laws, including bans on TAPS at PoS. However, little is known about how these laws are implemented, monitored, and enforced in practice. This study explored the facilitators and barriers to implementing, monitoring compliance with, and enforcing TAPS laws at PoS in Ethiopia.
Qualitative interviews with 41 key informants were conducted between December 2022 and January 2023 across 10 purposively selected cities. Participants included policy implementers and stakeholders from government agencies, civil society organizations (CSOs), and international partners. Participants were purposively selected from national and sub-national actors involved in tobacco control, including government agencies (MoH, EFDA, Ministry of Trade, regional health and trade authorities, regulatory bodies, and research institutions) and non-governmental stakeholders (WHO Ethiopia, professional associations, and CSOs). Semi-structured interview guides were developed and administered in local languages. Interviews were audio-recorded, transcribed verbatim, translated into English, and analyzed thematically using ATLAS.ti software.
Key facilitators included strong tobacco control laws (Proclamation No. 1112/2019), federal-level political commitment, and the national tobacco control committee (NTCC). Barriers included the absence of EFDA structures at lower administrative levels, a lack of regionally adapted tobacco control laws, limited dedicated tobacco control departments, unclear enforcement mandates, advertisement of illicit tobacco products, not being a prioritized agenda, low awareness among non-health departments and retailers, tobacco industry interference, and, in some areas, a culture that normalizes tobacco smoking.
Strong legislation banning 100% of TAPS and the presence of a national tobacco control committee support implementation; however, enforcement remains limited by structural, operational, and socio-cultural challenges. Enhancing compliance requires strengthening regional regulations, establishing clear institutional frameworks, raising stakeholder awareness about the tactics of the tobacco industry, and ensuring adequate allocation of human and financial resources, particularly in regions with a high prevalence of illicit tobacco products, to achieve the intended public health impact of TAPS laws in Ethiopia.
Introduction
Tobacco use remains a leading cause of preventable morbidity and mortality worldwide, contributing to premature death, a wide range of chronic diseases, and reduced quality of life [1]. A major driver of this burden is the retail environment, which serves as a key channel for tobacco advertising and promotion, particularly in low- and middle-income countries (LMICs), where tobacco marketing remains widespread [2–4]. In 2017, Japan Tobacco International (JTI) obtained a controlling interest in Ethiopia’s National Tobacco Enterprise (NTE) after acquiring 40% of the company’s shares for US$510 million in 2016 and a further 30% stake for US$434 million in 2017, bringing its ownership to 70% [5]. Tobacco industries exploit regulatory gaps through targeted marketing, political lobbying, and other manipulative strategies, and undermine tobacco-control policies [2,3]. Among these strategies, tobacco advertising and promotion at points of sale (PoS) play a significant role, especially in shaping young people’s perceptions and behaviors. For example, exposure to tobacco advertising and promotion at PoS has been shown to significantly increase the likelihood of smoking initiation among adolescents [6,7]. Recent evidence shows that such exposure remains high among adolescents [8]. These concerns have prompted strong global and national tobacco control responses, particularly through the World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC), which calls for comprehensive bans on advertising, promotion, and sponsorship (TAPS) [9,10]. Ethiopia is among the countries that signed the WHO Framework Convention on Tobacco Control (WHO FCTC) in 2004 and subsequently ratified it in 2014. Banning advertising and product displays at PoS reduces exposure to tobacco marketing, lowers youth smoking initiation, decreases overall smoking prevalence, and curbs impulse purchases among smokers [11–13]. A study showed that comprehensive tobacco advertisement, promotion, and sponsorship (TAPS) bans are associated with a 20% reduction in current smoking and a 37% reduction in the risk of smoking initiation [14].
Reading this evidence
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This briefing makes the source accessible within the wider public health desk. It does not assess an individual patient or certify a product. When considering relevance to another health system, examine the original authors’ account of context and limitations, then seek local implementation evidence. The related reporting below provides other studies to read alongside this one; it is a topic connection, rather than a claim that their results are directly comparable.
© 2026 Selamawit Hirpa, Noreen Dadirai Mdege, Terefe Gelibo Argefa, Selam Abraham Kassa, Wakgari Deressa. Excerpts reproduced under CC BY. Selection, formatting and contextual notes by Health Signal. The researchers are the authors of the source study, not members of Health Signal’s staff.
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