Cancer Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran.
Student research Center, Qazvin University of Medical Sciences, Qazvin, Iran.
PLoS One. 2024 Feb 23;19(2):e0297045. doi: 10.1371/journal.pone.0297045. eCollection 2024.
This study aimed to assess the association between the 10-year implementation of tobacco control policies, cigarette affordability index and changes in tobacco smoking prevalence across Eastern Mediterranean (EMR) countries.
An ecologic study was conducted using EMR countries as the analytical unit. Data from three sources were utilized: the MPOWER scale to measure tobacco control policy implementation (2010-2020), the tobacco affordability index (expressed as a percentage of GDP per capita required to purchase 2000 cigarettes, from 2010 to 2020), and national tobacco smoking prevalence data for EMR countries (2010-2023). Linear Fixed-effect regression was employed to investigate associations between changes in MPOWER scores, the cigarette affordability index, and alterations in tobacco prevalence over a decade.
Statistically significant inverse associations were observed between changes in MPOWER scores and tobacco smoking prevalence among both men and women in EMR countries (P-value<0.05). Each unit increase in MPOWER score corresponded to a 0.26% reduction in tobacco prevalence among men and a 0.12% reduction among women. The regression model revealed that each unit increase in the cigarette affordability index was linked to a 0.9% decrease in tobacco smoking prevalence across EMR countries (P-value<0.05). Furthermore, even after adjusting for multiple confounders, significant inverse associations were noted between tobacco monitoring (β = -0.41), health warning (β = -0.45), and changes in tobacco smoking prevalence (P-value<0.05).
This study underscored the effectiveness of enhancing the implementation of tobacco control policies and increasing the cigarette affordability index as preventive measures to reduce tobacco smoking prevalence in EMR countries over the past decade.
本研究旨在评估在东地中海地区（EMR）国家实施烟草控制政策 10 年、香烟可负担指数与烟草使用流行率变化之间的关系。
采用生态研究方法，以 EMR 国家为分析单位。使用了三个来源的数据：衡量烟草控制政策实施情况的 MPOWER 量表（2010-2020 年）、香烟可负担指数（表示为购买 2000 支香烟所需人均 GDP 的百分比，2010-2020 年）和 EMR 国家的国家烟草使用流行率数据（2010-2023 年）。采用线性固定效应回归分析 10 年来 MPOWER 评分变化、香烟可负担指数与烟草流行率变化之间的关系。
EMR 国家男性和女性 MPOWER 评分变化与烟草使用流行率之间存在显著负相关（P<0.05）。MPOWER 评分每增加一个单位，男性烟草流行率降低 0.26%，女性降低 0.12%。回归模型显示，香烟可负担指数每增加一个单位，EMR 国家的烟草使用流行率降低 0.9%（P<0.05）。此外，即使在调整了多个混杂因素后，仍观察到烟草监测（β=-0.41）和健康警示（β=-0.45）与烟草使用流行率变化之间存在显著负相关（P<0.05）。
本研究强调了加强烟草控制政策实施和提高香烟可负担指数作为过去十年在 EMR 国家减少烟草使用流行率的预防措施的有效性。
