The status of tobacco control in the Eastern Mediterranean Region: progress in the implementation of the MPOWER measures

El-Awa, Fatimah; Bettcher, Douglas; Al-Lawati, Jawad; Alebshehy, Raouf; Gouda, Hebe; Fraser, Charles P

doi:10.26719/2020.26.1.102

Cited by 11 publications

(8 citation statements)

References 5 publications

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“…Unlike this study, several previous studies conducted in GCC countries [ 26 , 27 , 33 , 34 ] focused more on the implementation of the MPOWER package that includes measures targeting the demand-side of tobacco such as raising tobacco taxes, enforcing smoke-free, offering cessation for those who want to quit, educating people about the harmful use of tobacco, and banning tobacco marketing activities. Although these studies reported the advancement of implementing FCTC measures in GCC countries, none of them have assessed the implementation of supply-reduction measures [ 26 , 27 , 33 , 34 ]. Due to the little support given by global consensus toward policies targeting the supply of tobacco, there is a scant amount of literature focusing on supply-reduction measures and their effectiveness on tobacco use compared to demand-reduction measures [ 17 , 35 ].…”

Section: Discussionmentioning

confidence: 99%

Implementation of tobacco control measures in the Gulf Cooperation Council countries, 2008–2020

Monshi

Ibrahim

2021

Subst Abuse Treat Prev Policy

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Background The World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC) was developed to assist nations in reducing the demand and supply of tobacco. As of 2020, 182 nations joined the FCTC, agreeing to implement the recommended tobacco control measures. The Gulf Cooperation Council (GCC) countries, including Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and United Arab Emirates (UAE) ratified the WHO FCTC by August 2006. Given the unique political, cultural, and religious context – and known tobacco industry efforts to influence tobacco use- in these nations, a careful examination of the translation of FCTC measures into policy is needed. This study aimed to assess the implementation of FCTC tobacco control measures at the national level within the six GCC countries. Method We collected and coded the FCTC measures that were implemented in the GCC countries. We examined trends and variations of the implementation between 2008 and 2020. Results GCC countries implemented most FCTC measures targeting the demand for and supply of tobacco, with some variation among countries. Bahrain and Qatar were more comprehensively implementing FCTC measures while Kuwait and Oman implemented the least number of the FCTC measures. Implementing measures related to tobacco prices and eliminating the illicit tobacco trade has slowly progressed in GCC countries. All GCC countries entirely banned smoking in workplaces while three countries implemented a partial ban in restaurants. Only Oman has restrictions on tobacco ads shown in media. There is progress in implementing FCTC measures related to tobacco packaging, cessation, and sale to minors in most GCC countries. Conclusions Given the influence of the tobacco industry in the Gulf region, the findings suggest a need for ongoing surveillance to monitor the proliferation of tobacco control measures and evaluate their effectiveness. Efforts required to address tobacco use should correspond to the unique political and cultural background of the GCC countries.

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Section: Discussionmentioning

confidence: 99%

Implementation of tobacco control measures in the Gulf Cooperation Council countries, 2008–2020

Monshi

Ibrahim

2021

Subst Abuse Treat Prev Policy

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“… 49 Also, the MPOWER program introduced by WHO in 2008 with funding from The Bill & Melinda Gates Foundation and The Bloomberg Philanthropies has been effective in promoting tobacco demand reduction policies. 34–36 , 50 …”

Section: Discussionmentioning

confidence: 99%

“… 6 , 32 Provisions of the FCTC that set targets for the speed of implementation of health warning labels and TAPS restrictions (Articles 11 [HWL 8 , 9 , 33 ] and 13 [TAPS] 7 ) are the most implemented 32 while taxation measures lag behind. 11 , 34 The FCTC accelerated the adoption of smoke-free policies, 10 , 33 but they remained the least implemented measure among 22 Eastern Mediterranean countries. 35 , 36 …”

Section: Introductionmentioning

confidence: 99%

Global Implementation of Tobacco Demand Reduction Measures Specified in Framework Convention on Tobacco Control

Hiilamo

Glantz

2021

Nicotine &Amp; Tobacco Research

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Objectives The world first global health treaty, WHO Framework Convention on Tobacco Control (FCTC) aims to reduce tobacco product demand by focusing on tobacco taxes, smoking bans, health warning labels and tobacco advertising bans. Previous studies almost unanimously suggest that FCTC has prompted countries to implement more effective tobacco demand reduction policies. By taking into account the pre-FCTC status, country income level and state capacity we studied if ratifying FCTC was associated with tobacco demand reduction measures in 2018/2019. Methods We used logistic regression to assess the association of FCTC ratification with adoption demand reduction measures, accounting for years since ratification, baseline status and other covariates. Results Except for taxes, state of tobacco policy implementation before FCTC ratification did not predict adoption of FCTC policies. Time since FCTC ratification was associated with implementing smoking bans and pictorial HWLs. In contrast, while the tax rate prior to FCTC ratification was positively associated with increased taxes after FCTC ratification, time since FCTC ratification was marginally negatively associated with increases in tobacco taxes. Conclusions While the FCTC was followed by implementation of compliant demand reduction policies, there are still many parties that have not implemented the FCTC, particularly increasing taxes and ending tobacco advertising and promotions. Implications We assessed changes in tobacco demand reductions measures over 22 years in 193 countries.By using internal tobacco industry documents, we were able establish a baseline before the FCTC negotiations.Unlike previous studies we included four tobacco demand reductions measures: tobacco taxes, smoking bans, health warning labels and tobacco advertising ban, The limitation of the study is that we do not have data to describe if demand reduction measures are actually enforced or what their effect on tobacco consumption is.

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“…3 A growing body of evidence globally, including that from LMICs, clearly demonstrate that tobacco taxes are a powerful tool for reducing tobacco use while providing a reliable source of government revenues. 4 The Eastern Mediterranean region has the lowest average prices of tobacco products among all WHO regions, 5 and is the only region for which smoking prevalence has been projected to increase by 2025. 6 Tobacco product prices are an important factor when considering that decreasing affordability is the most effective strategy to reduce the uptake of smoking among young people.…”

Section: Introductionmentioning

confidence: 99%

Own-price and cross-price elasticities of demand for cigarettes and waterpipe tobacco in three Eastern Mediterranean countries: a volumetric choice experiment

et al. 2021

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BackgroundWaterpipe tobacco smoking rates in the Eastern Mediterranean region are among the highest worldwide, yet little evidence exists on its economics. Estimates of demand elasticities for tobacco products are largely limited to cigarettes. This study aimed to estimate own-price and cross-price elasticities of demand for cigarettes and waterpipe tobacco products in Lebanon, Jordan and Palestine.MethodsA volumetric choice experiment was conducted using nationally representative household surveys. The choice experiment elicited respondents’ stated purchases of eight cigarette and waterpipe tobacco product varieties by hypothetically varying prices. Data were analysed using zero-inflated Poisson models that yielded demand elasticity estimates of cigarette and waterpipe tobacco consumption.ResultsThe study included 1680 participants in Lebanon (50% female), 1925 in Jordan (44.6% female) and 1679 in Palestine (50% female). We found the demand for premium cigarettes to be price elastic (range, −1.0 to −1.2) across all three countries, whereas the demand for discount cigarettes was less elastic than premium cigarettes in Lebanon (−0.6) and Jordan (−0.7) and more elastic in Palestine (−1.2). The demand for premium waterpipe tobacco was highly elastic in Lebanon (−1.9), moderately elastic in Jordan (−0.6) and inelastic in Palestine (0.2). The cross-price elasticity between cigarettes and waterpipe tobacco was near zero, suggesting that the two products are not considered to be close substitutes by consumers.ConclusionsThese results serve as a strong evidence base for developing and implementing fiscal policies for tobacco control in the Eastern Mediterranean region that address cigarettes and waterpipe tobacco products.

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The status of tobacco control in the Eastern Mediterranean Region: progress in the implementation of the MPOWER measures

Cited by 11 publications

References 5 publications

Implementation of tobacco control measures in the Gulf Cooperation Council countries, 2008–2020

Implementation of tobacco control measures in the Gulf Cooperation Council countries, 2008–2020

Global Implementation of Tobacco Demand Reduction Measures Specified in Framework Convention on Tobacco Control

Own-price and cross-price elasticities of demand for cigarettes and waterpipe tobacco in three Eastern Mediterranean countries: a volumetric choice experiment

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