'To be honest, I'm really scared': perceptions and experiences of intimidation in the LMIC-based tobacco control...

It is well-evidenced that environmental or human rights advocacy comes with risks for those involved. Much less is known about the risks of tobacco control advocacy despite the emphasis on tobacco industry conduct. This study explores the experiences and perceptions of intimidation among members of the tobacco control community in low- and middle-income countries (LMICs).

We interviewed six experts representing each of the World Health Organization (WHO) regions to inform an online survey conducted among the LMIC-based tobacco control community. Thematic analysis was used for analysing qualitative data while quantitative data were analysed descriptively.

Twenty-three participants from five WHO regions completed the survey. Almost three-quarters of survey participants reported that they, or another member of the tobacco control community in their country, had experienced intimidation. The most frequently reported forms of intimidation were discreditation on social or traditional media, legal threats/action and threatening messages. Physical intimidation, theft/burglary, cyberattacks and surveillance were individually rare but reported collectively by over 40% of participants. Results suggested intimidation might be increasing and changing in nature, and undermines tobacco control efforts: it affects organisations' capacity and agenda, their ability to build relationships with those needed to advance policy, as well as the well-being of individuals. Participants used a range of strategies in response to intimidation and reported that they would benefit from better support.

This exploratory study suggests that intimidation is a crucial challenge for the tobacco control community. There are several measures the global tobacco control community could take, including establishing an international support mechanism and building capacity to deal with intimidation and draw attention to it.