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Application of the Abridged SimSmoke model to four Eastern Mediterranean countries
  1. David T Levy1,
  2. Heba Fouad2,
  3. Jeffrey Levy3,
  4. Anca D Dragomir1,
  5. Fatima El Awa2
  1. 1Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, USA
  2. 2WHO-EMRO, Cairo-Nasr City, Egypt, USA
  3. 3Silver Spring, Maryland, USA
  1. Correspondence to Dr David T Levy, Lombardi Comprehensive Cancer Centre, Georgetown University, 3300 Whitehaven St, NW, Suite 4100, Washington, DC 20007, USA; dl777{at}


Introduction The WHO established the MPOWER policy package to boost the implementation of the WHO Framework Convention for Tobacco Control (WHO FCTC) in 2008 and to provide practical guidance on policies effective at reducing smoking rates. An easily applied Abridged SimSmoke was developed to help countries gauge the effect of these policies using data from the WHO MPOWER/WHO Report (MPOWER Report) and is applied to four Eastern Mediterranean countries.

Methods The number of smokers in a country is calculated using the country's smoking prevalence and population. Policy effect sizes, based on previously validated SimSmoke models, are applied to the smoker populations to determine the reduction in the number of smokers resulting from implementing policies. The number of smoking-attributable deaths is derived based on findings that half of those smokers alive today will die from smoking.

Results Within 40 years, implementing the complete set of MPOWER policies is projected to reduce smoking prevalence by 29% (range 15%, 41%) and avert almost 1 (range 0.5, 1.4) million deaths in Egypt, reduce smoking prevalence by 52% (range 36%, 66%) and avert 156 000 (106 000, 196 000) deaths in Lebanon, reduce smoking prevalence by 56% (range 40%, 69%) and avert 3.5 (range 2.5, 4.3) million deaths in Pakistan, and reduce smoking prevalence by 37% (range 21%, 51%) and avert 245 000 (range 138 000, 334 000) deaths in Tunisia.

Conclusions The Abridged SimSmoke model has been used to show the number of deaths from smoking and how MPOWER policies can be used to reach the WHO non-communicable deaths voluntary target for cigarette use reduction in four countries.

  • Global health
  • Low/Middle income country
  • Prevention
  • Public policy

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