Abstract
The study aimed to describe worldwide levels and trends of tobacco control policy by comparing low and middle income countries with other income categories from 2007 to 2014 and to analyze the corresponding relation to recent changes in smoking prevalence. Policy measure data representing years 2007 to 2014 were collected from all available World Health Organization (WHO) reports on the global tobacco epidemic. Corresponding policy percentage scores (PS) were calculated based on MPOWER measures. Age-standardized smoking prevalence data for years 2010 and 2015 were collected from the WHO Global Health Observatory Data Repository. Trends of PS were analysed with respect to WHO region and OECD country income category. Scatter plots and regression analysis were used to depict the relationship between tobacco control policy of 2010 and change in smoking prevalence between 2015 and 2010 by sex and income category. Combined PS for all countries increased significantly from 47% in 2007 to 61% by 2014 (p < 0.001). When grouped by income category and region, policies were strengthened in all categories, albeit with varying progression. By 2014, tobacco control policy legislation had reached 45% in the Least Developed Countries (LDCs), 59% in Low Middle Income Countries (LMICs), 66% in Upper Middle Income Countries (UMICs) and 70% in High Income Countries (HICs). Overall, there was a negative relationship between higher policy scores and change in smoking prevalence. Although policy strengthening had been conducted between 2007 and 2014, room for considerable global improvement remains, particularly in LDCs.
Highlights
Tobacco consumption and smoke exposure can have devastating health, social, economic and environmental consequences at both individual and global levels [1]
For the secondary study aim, we examined the association between tobacco control policy and the change in current tobacco smoking by an ecological study
Regression modelling showed a negative association between World Health Organization (WHO) recommended policy legislations and increase in smoking prevalence, which was stronger in males than females and only significant in males
Summary
Tobacco consumption and smoke exposure can have devastating health, social, economic and environmental consequences at both individual and global levels [1]. Scientific evidence has routinely shown that exposure to tobacco smoke causes death, disease and disability [2], the tobacco epidemic continues to persist at a global scale with a growing emphasis on low and middle income countries. Tobacco is contributing to approximately 6 million deaths each year, with 5 million of those deaths directly attributable to tobacco use [3]. In 2004, tobacco was responsible for 4%, 11% and 18% of total deaths in low, middle and high income countries, respectively [4]. A higher tobacco-related mortality can been seen in men than women, and the American and European regions claim the highest proportion of deaths attributable to tobacco [2]
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