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Seven years of progress in tobacco control: an evaluation of the effect of nations meeting the highest level MPOWER measures between 2007 and 2014
  1. David T Levy,
  2. Zhe Yuan,
  3. Yuying Luo,
  4. Darren Mays
  1. Department of Oncology, Georgetown University Medical Center, Cancer Prevention & Control Program, Lombardi Comprehensive Cancer Center, Washington, DC, USA
  1. Correspondence to Dr David T Levy, Department of Oncology, Georgetown University Medical Center, Cancer Prevention & Control Program, Lombardi Comprehensive Cancer Center, 3300 Whitehaven Street NW, Suite 4100, Washington, DC 20007, USA; dl777{at}


Objective Since WHO released the package of six MPOWER measures to assist nations with implementing the WHO Framework Convention for Tobacco Control (FCTC), 88 countries adopted at least one highest level MPOWER measure. We estimated the subsequent reduction in smoking-related deaths from all new highest level measures adopted between 2007 and 2014.

Methods Policy effect sizes based on previously validated SimSmoke models were applied to the number of smokers in each nation to determine the reduction in the number of smokers from policy adoption. On the basis of research that half of all smokers die from smoking, we derived the smoking-attributable deaths (SADs) averted of those smokers alive today.

Findings In total, 88 countries adopted at least one highest level MPOWER policy between 2007 and 2014, resulting in almost 22 million fewer projected SADs. The largest number of future SADs averted was due to increased cigarette taxes (7.0 million), followed by comprehensive smoke-free laws (5.4 million), large graphic health warnings (4.1 million), comprehensive marketing bans (3.8 million) and comprehensive cessation interventions (1.5 million).

Conclusions These findings demonstrate the immense public health impact of tobacco control policies adopted globally since the WHO-FCTC and highlight the importance of more countries adopting highest level MPOWER measures to reduce the global burden of tobacco use. Substantial additional progress could be made, especially if heavily populated nations with high smoking prevalence were to reach highest level MPOWER measures.

  • Public policy
  • Smoking Caused Disease
  • Advocacy
  • Global health
  • Low/Middle income country

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  • Collaborators Jennifer Ellis, Bloomberg Philanthropies.

  • Contributors DTL conceived of the idea, managed the study, wrote the initial draft and revisions. ZY and YL collected the data, conducted the analysis and helped to revise the paper. DM helped to write and revise the paper.

  • Funding DTL received funding from Bloomberg Philanthropies through the International Union against Tuberculosis and Lung Disease to conduct this study. The funder helped in the collection of data and interpretation of data. DTL had access to all data in the study and had final responsibility for content of the article and the decision to submit for publication. DTL has also received funding from the Cancer Intervention and Surveillance and Modeling Network (CISNET of DCPS, NCI under grant U01-CA97450-020) for general development of the SimSmoke model and from the National Institute on Drug Abuse, under grant R01DA036497 to disseminate results. Preparation of this publication was also supported in part by a grant from the National Institutes of Health (NIH) and the Food and Drug Administration Center for Tobacco Products to DM (K07CA172217).

  • Disclaimer The content is solely the responsibility of the authors and does not necessarily represent the official views of the funders.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement We will share the data and programmes used in the article.