Promoting Global Adult Tobacco Control in South-East Asian Region: Nine-year Retrospective Analysis using World Health Organization MPOWER

Abstract

It is noted that fire without smoke smokeless tobacco is one of the major scourges in the South-east Asia subcontinent, particularly India. It not only includes adult men and women users but a sizeable chunk entails Indian teenagers. What is worrying though, the models attempting to capture the global usage does not really has much to offer due to paucity of global data. That said, World Health Organization (WHO) has been at the forefront foreshadowing trends and using myriad policy initiatives to help developing countries combat the malaise. Mpower is one such policy framework by the WHO to help countries implement and manage tobacco control, the success of this country-tailored demand reduction interventionist program has lifted a country like Turkey from being one of the highest puffers to drastically reducing its tobacco usage and free smoking indoors by 100%. MPOWER has shown a stellar performance in averting 7.4 million deaths, 30 countries with more than 1 billion people have best pictorially represented health warnings and labels, smoke-free laws and appropriate taxation rules to curb the menace. Aim: In light of aforementioned, the aim of this study was to perform the quantitative analysis of WHO report on tobacco control and to get an insight to what extend the program has been successful and the best practices that could potentially be replicated. Methodology: The MPOWER composite score was built by employing 6 MPOWER scores using the validated checklist outlined by Iranian and international tobacco control specialists in their study on tobacco control. The independent scores and cutoffs thereof were set in consonance with the key sections of the MPOWER 2011 report. Results: MPOWER composite scores that measured policy implementation were then linked to cigarette smoking prevalence and consumption data. An encouraging trend was observed, for example, the highest scores were observable in 2019 and there was noticeable increase in scores of adult daily smoking prevalence (<15 years), cessation programs, and in health warning on cigarette packages. Laws are toothless without adequate intervention at ground level and it was patently clear from monitoring of prevalence data, for example, there was abysmally poor compliance rate, especially with respect to advertisements and other smoke –free policies. The results were mixed at best. Conclusion: The dozen countries present themselves as the best replica in the implementation and enforcement of tobacco control program; however, little tweaks here and there to tailor it in accordance with socio-cultural aspects of countries are warranted.