PT - JOURNAL ARTICLE AU - Husain, Muhammad Jami AU - Datta, Biplab Kumar AU - Nargis, Nigar AU - Iglesias, Roberto AU - Perucic, Anne-Marie AU - Ahluwalia, Indu B AU - Tripp, Angela AU - Fatehin, Sohani AU - Husain, Muhammad Mudabbir AU - Kostova, Deliana AU - Richter, Patricia TI - Revisiting the association between worldwide implementation of the MPOWER package and smoking prevalence, 2008–2017 AID - 10.1136/tobaccocontrol-2020-055758 DP - 2021 Nov 01 TA - Tobacco Control PG - 630--637 VI - 30 IP - 6 4099 - http://tobaccocontrol.bmj.com/content/30/6/630.short 4100 - http://tobaccocontrol.bmj.com/content/30/6/630.full SO - Tob Control2021 Nov 01; 30 AB - Background We revisited the association between progress in MPOWER implementation from 2008 to 2016 and smoking prevalence from 2009 to 2017 and offered an in-depth understanding of differential outcomes for various country groups.Methods We used data from six rounds of the WHO Reports on the Global Tobacco Epidemic and calculated a composite MPOWER Score for each country in each period. We categorised the countries in four initial conditions based on their tobacco control preparedness measured by MPOWER score in 2008 and smoking burden measured by age-adjusted adult daily smoking prevalence in 2006: (1) High MPOWER – high prevalence (HM-HP). (2) High MPOWER – low prevalence (HM-LP). (3) Low MPOWER – high prevalence (LM-HP). (4) Low MPOWER – low prevalence (LM-LP). We estimated the association of age-adjusted adult daily smoking prevalence with MPOWER Score and cigarette tax rates using two-way fixed-effects panel regression models including both year and country fixed effects.Results A unit increase of the MPOWER Score was associated with 0.39 and 0.50 percentage points decrease in adult daily smoking prevalence for HM-HP and HM-LP countries, respectively. When tax rate was controlled for separately from MPOWE, an increase in tax rate showed a negative association with daily smoking prevalence for HM-HP and LM-LP countries, while the MPOWE Score showed a negative association for all initial condition country groups except for LM-LP countries.Conclusion A decade after the introduction of the WHO MPOWER package, we observed that the countries with higher initial tobacco control preparedness and higher smoking burden were able to reduce the adult daily smoking prevalence significantly.Data are available in a public, open access repository. We used data from the six rounds of the WHO Reports on the Global Tobacco Epidemic, available at https://www.who.int/tobacco/mpower/en/