Abstract
BackgroundGovernment interventions are critical to addressing the global tobacco epidemic, a major public health problem that continues to deepen. We systematically synthesize research evidence on the effectiveness of government tobacco control policies promoted by the Framework Convention on Tobacco Control (FCTC), supporting the implementation of this international treaty on the tenth anniversary of it entering into force.MethodsAn overview of systematic reviews was prepared through systematic searches of five electronic databases, published up to March 2014. Additional reviews were retrieved from monthly updates until August 2014, consultations with tobacco control experts and a targeted search for reviews on mass media interventions. Reviews were assessed according to predefined inclusion criteria, and ratings of methodological quality were either extracted from source databases or independently scored.ResultsOf 612 reviews retrieved, 45 reviews met the inclusion criteria and 14 more were identified from monthly updates, expert consultations and a targeted search, resulting in 59 included reviews summarizing over 1150 primary studies. The 38 strong and moderate quality reviews published since 2000 were prioritized in the qualitative synthesis. Protecting people from tobacco smoke was the most strongly supported government intervention, with smoke-free policies associated with decreased smoking behaviour, secondhand smoke exposure and adverse health outcomes. Raising taxes on tobacco products also consistently demonstrated reductions in smoking behaviour. Tobacco product packaging interventions and anti-tobacco mass media campaigns may decrease smoking behaviour, with the latter likely an important part of larger multicomponent programs. Financial interventions for smoking cessation are most effective when targeted at smokers to reduce the cost of cessation products, but incentivizing quitting may be effective as well. Although the findings for bans on tobacco advertising were inconclusive, other evidence suggests they remain an important intervention.ConclusionWhen designing and implementing tobacco control programs, governments should prioritize smoking bans and price increases of tobacco products followed by other interventions. Additional studies are needed on the various factors that can influence a policy’s effectiveness and feasibility such as cost, local context, political barriers and implementation strategies.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-015-2041-6) contains supplementary material, which is available to authorized users.
Highlights
Government interventions are critical to addressing the global tobacco epidemic, a major public health problem that continues to deepen
The year 2015 marks the tenth anniversary since the World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC) came into force, the first international treaty specially adopted through WHO
The literature on youth access interventions is inconclusive; restrictions, if they are effective, appear to depend on robust enforcement. Principal findings This systematic overview of systematic reviews summarizes the research evidence on the likely health-related effects of government tobacco control policies promoted in the FCTC, identifying gaps in the literature and providing a framework for policy deliberations and future research
Summary
Government interventions are critical to addressing the global tobacco epidemic, a major public health problem that continues to deepen. The global tobacco epidemic is a major public health problem that continues to deepen, with nearly 1 billion smokers worldwide in 2012 [1] It is the leading cause of preventable death, resulting in approximately 6 million unnecessary deaths per year [2, 3]. The year 2015 marks the tenth anniversary since the World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC) came into force, the first international treaty specially adopted through WHO. This instrument aims to reduce tobacco consumption and protect all people from tobacco exposure through provisions that direct countries to implement tobacco control programs [4]. The bi-annual reports that ratifying countries must submit show uneven progress [7]
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