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The effect of MPOWER on smoking prevalence
  1. Jolene Dubray1,
  2. Robert Schwartz1,2,
  3. Michael Chaiton1,
  4. Shawn O'Connor1,
  5. Joanna E Cohen1,3
  1. 1Ontario Tobacco Research Unit, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
  2. 2Centre for Addiction and Mental Health, Toronto, Ontario, Canada
  3. 3Institute for Global Tobacco Control, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
  1. Correspondence to Jolene Dubray, Ontario Tobacco Research Unit, c/o Dalla Lana School of Public Health, University of Toronto, 530–155 College Street, Toronto, ON M5T 3M7, Canada; jolene.dubray{at}utoronto.ca

Abstract

Objective To examine the effect of varying levels of comprehensive tobacco control on smoking in a global context.

Methods Using data from WHO's Reports on the Global Tobacco Epidemic, scatter plots were produced to visualise the relationship between comprehensive tobacco control policy (2008 MPOWER composite score) and change in current tobacco smoking between 2006 and 2009. Fixed-effect regression models assessed the effect of changes in each MPOWER measure on changes in current tobacco smoking between 2006 and 2009. All analyses were stratified by sex.

Results Overall, countries with higher MPOWER composite scores experienced greater decreases in current tobacco smoking between the years 2006 and 2009. Regression analyses revealed that the M and R measures showed a negative association with current tobacco smoking over time. Current tobacco smoking decreased (1.07 percentage points for males, 1.04 percentage points for females) with each increase in score value for monitoring tobacco use (M). Also, current tobacco smoking decreased (0.95 percentage points for males, 0.41 percentage points for females) with each increase in score value for raising taxes on tobacco (R). The effect of the MPOWER measures on current tobacco smoking varied by country income status (P measure in the female analysis; p<0.05) and/or by WHO region (M, P and O measures in the male analysis; p<0.05).

Conclusions Higher levels of MPOWER combined, as well as continued and frequent monitoring of tobacco use (M) and increasing taxation (R), were associated with a decrease in current tobacco smoking over time.

  • Global health
  • Public policy
  • Low/Middle income country
  • Surveillance and monitoring
  • Taxation

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