Deployment of targeted smoking demand-reduction measures may be significantly associated with decreases in smoking prevalence worldwide, according to a study published March 21 in The Lancet Public Health.

Since 2003, the World Health Organization Framework Convention on Tobacco Control (WHO FCTC) has led a coordinated effort to decrease global tobacco use by recommending several demand-reduction measures.

Shannon Gravely, PhD, et al., analyzed WHO data from 126 countries to examine the association between the demand-reduction measures implemented between 2007 and 2014 and smoking prevalence estimates between 2005 and 2015. The demand-reduction measures were taxation, smoke-free policies, warning labels, bans on tobacco advertising, promotion and sponsorship, and smoking cessation programs.

Results showed that overall, there was a significant increase in the proportion of countries that implemented each key measure between 2007 and 2014. The mean smoking prevalence for all 126 countries was 24.73 percent in 2005 and 22.18 percent in 2015, an average decrease in prevalence of 2.55 percent. Unadjusted linear regression showed that increases in implementations of key measures between 2007 and 2014 were "significantly associated with a decrease in smoking prevalence between 2005 and 2015." Further, each additional measure implemented was associated with an average decrease in smoking prevalence of 1.57 percent and an average relative decrease of 7.09 percent.

"[Our study] highlights the importance of tobacco control in two global initiatives that have set goals of markedly reducing non-communicable diseases through reducing tobacco use: WHO's Global Action Plan, and the UN's Sustainable Development Goals, which calls on countries to 'strengthen the implementation of the [WHO FCTC] in all countries, as appropriate,'" the authors conclude.

In an accompanying editorial, Kenneth E. Warner, MD, notes that the study affirms the validity of the demand-reduction measures, and commends the authors for reinforcing that "tobacco control policy matters." "Let us hope that this study increases adoption of all of the core evidence-based demand-reduction policy interventions, especially including raising taxes, the highly effective intervention that has lagged in terms of adoption," he adds.

Keywords: Advertising, Conservation of Natural Resources, Linear Models, Prevalence, Public Health, Smoke-Free Policy, Smoking, Smoking Cessation, Taxes, Tobacco, Tobacco Use, Tobacco Use Disorder, World Health Organization

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