Background:
Guatemala is an upper-middle-income country with weak tobacco control. In 2018 a law proposal was introduced to Congress to include pictorial health warnings (PHW), restrict advertising and ban tobacco industry contributions.

Objectives:
We sought to evaluate tobacco industry interference in the drafting, approval, and implementation of tobacco control policies in Guatemala.

Methods:
Using the Tobacco Industry Interference Index (TIII) from the Southeast Asia Tobacco Control Alliance (SEATCA) we assessed tobacco industry interference. Three researchers compiled information publicly available between 2020-2021 using online search engines and governmental agencies, and local news sources.

Results:
Guatemala´s government has no mechanisms to regulate the interaction with the industry, nor requires disclosure or prohibits contributions of any type. In 2018, San Carlos University proposed Law 5461 “Law for Tobacco Control and its Products” to Congress and was assigned to the Health Commission. The proposal was discussed 6 times between April to August 2019 by the Commission and has not been discussed since then. During this period the industry edited the proposal and was given time frames to do so. In addition, after the COVID-19 lockdown, tobacco front groups made contributions estimated in USD 2 million (diagnostic tests and medical supplies). Moreover, Tabacalera Centro Americana, a Philip Morris subsidiary, supports The Mesa de Competitividad de Alta Verapaz (MancoVerapaz), a project that seeks to economically develop the Northern area of Guatemala. MancoVerapaz has invested to this date USD 90 million.

Conclusions:
Law proposal 5461 has not been approved by Congress in Guatemala due in part to tobacco industry interference. Furthermore, the Guatemalan government (including Ministries) and Congress currently receive contributions from the industry. This close relationship is, in part, due to the lack of regulations and specific policies to control tobacco industry interference in Guatemala.