Abstract
INTRODUCTION: The WHO Framework Convention on Tobacco Control has been aligned with Thailand's National Tobacco Control Strategy (NTCS), which has been implemented for over three decades. However, policy evaluation is essential to improve its effectiveness. This formative evaluation study aims to identify challenges and provide suggestions for implementing the current NTCS 2022-2027 at both national and operational levels. METHODS: Data collection for this qualitative research involved document reviews and in-depth interviews using a semi-structured interview guide. Thematic analysis was used to identify and analyze data from 15 informants who were purposively selected based on their influential positions, expertise, and experience in NTCS implementation. RESULTS: Thailand's NTCS operates through both national and operational stakeholders. The findings revealed multifaceted challenges and suggestions across these levels, categorized into six key areas. First, the gaps in strategic coordination and prioritization reinforced the need to strengthen intersectoral partnerships to achieve tobacco control as a national priority. Second, problems with monitoring as well as evaluation and reporting processes highlighted the need for clearly defined key performance indicators and timelines. Third, role clarity-related gaps at the 'tobacco control focal point' revealed a need for capacity building and strategic management support. Fourth, policy dissemination was impeded by one-way communication modes, emphasizing the importance of two-way communication to foster stakeholder engagement. Fifth, centralized budget management hindered ready matching of resources with regional needs, urging the implementation of decentralized management. Finally, the lack of innovation in tobacco control challenges demonstrated the need for knowledge-sharing mechanisms. CONCLUSIONS: The evaluation offers important insights to strengthen NTCS implementation through enhanced coordination, systematic monitoring, capacity development, policy dissemination, allocation of adequate funds, and promoting innovations. These results contribute to the evidence base for effective tobacco control strategy by providing tangible recommendations for policymakers.