title: The effect of MPOWER on smoking prevalence.
abstract: OBJECTIVE
  To examine the effect of varying levels of comprehensive tobacco control on smoking in a global context.
  
  
  METHODS
  Using data from WHO's Reports on the Global Tobacco Epidemic, scatter plots were produced to visualise the relationship between comprehensive tobacco control policy (2008 MPOWER composite score) and change in current tobacco smoking between 2006 and 2009. Fixed-effect regression models assessed the effect of changes in each MPOWER measure on changes in current tobacco smoking between 2006 and 2009. All analyses were stratified by sex.
  
  
  RESULTS
  Overall, countries with higher MPOWER composite scores experienced greater decreases in current tobacco smoking between the years 2006 and 2009. Regression analyses revealed that the M and R measures showed a negative association with current tobacco smoking over time. Current tobacco smoking decreased (1.07 percentage points for males, 1.04 percentage points for females) with each increase in score value for monitoring tobacco use (M). Also, current tobacco smoking decreased (0.95 percentage points for males, 0.41 percentage points for females) with each increase in score value for raising taxes on tobacco (R). The effect of the MPOWER measures on current tobacco smoking varied by country income status (P measure in the female analysis; p<0.05) and/or by WHO region (M, P and O measures in the male analysis; p<0.05).
  
  
  CONCLUSIONS
  Higher levels of MPOWER combined, as well as continued and frequent monitoring of tobacco use (M) and increasing taxation (R), were associated with a decrease in current tobacco smoking over time.
authors.affiliation: Ontario Tobacco Research Unit, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Jolene
authors.initials: J
authors.lastname: Dubray
authors.affiliation: Ontario Tobacco Research Unit, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
authors.forename: Robert
authors.initials: R
authors.lastname: Schwartz
authors.affiliation: Ontario Tobacco Research Unit, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Michael
authors.identifier: http://orcid.org/0000-0002-9589-2122
authors.initials: M
authors.lastname: Chaiton
authors.affiliation: Ontario Tobacco Research Unit, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Shawn
authors.initials: S
authors.lastname: O'Connor
authors.affiliation: Ontario Tobacco Research Unit, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada Institute for Global Tobacco Control, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
authors.forename: Joanna E
authors.initials: JE
authors.lastname: Cohen
mesh_terms: D005260:Female; D014943:Global Health; D006291:Health Policy; D006801:Humans; D008297:Male; D015995:Prevalence; D012044:Regression Analysis; D012737:Sex Factors; D012907:Smoking / Q000191:economics / Q000453:epidemiology*; D000074606:Smoking Prevention; D013660:Taxes / Q000191:economics*; D014944:World Health Organization
keywords: Global health; Low/Middle income country; Public policy; Surveillance and monitoring; Taxation