Impact of nations meeting the MPOWER targets between 2014 and 2016: an update

Objective Since the WHO released the Monitoring tobacco use and tobacco control policies; Protecting from the dangers of tobacco smoke; Offering help to quit tobacco; Warning the public about the dangers; Enforcing bans on advertising, promotion and sponsorship; and Raising tobacco taxes (MPOWER) policy package to assist nations with implementing the Framework Convention on Tobacco Control (FCTC), 88 countries have adopted at least one MPOWER policy at the highest level as of 2014. Building on previous evaluations, we estimated the reduction in smoking-attributable deaths (SADs) from all policies newly adopted at the highest level between 2014 and 2016. Methods For each nation that implemented highest level policies, the difference in policy effect sizes from previously validated SimSmoke models for the policies in effect in 2014 and 2016 were multiplied by the number of smokers in that nation to derive the reduction in the number of smokers. Based on research that half of all smokers die from smoking, we derived SADs averted. Findings In total, 43 nations adopted at least one highest-level MPOWER policy between 2014 and 2016, resulting in 14.6 million fewer SADs. The largest number of SADs averted were due to stronger health warnings (13.3 million), followed by raising taxes (0.6 million), increased marketing bans (0.4 million), smoke-free air laws (0.3 million) and cessation interventions (2500). Conclusion These findings demonstrate the continuing public health impact of tobacco control policies adopted globally since the FCTC, and highlight the importance of more countries adopting MPOWER policies at the highest level to reduce the global burden of tobacco use.