Tobacco control environment: Cross-sectional survey of policy implementation, social unacceptability, knowledge of tobacco health harms and relationship to quit ratio in 17 low-income, middle-income and high-income countries

Tobacco control environment: Cross-sectional survey of policy implementation, social unacceptability, knowledge of tobacco health harms and relationship to quit ratio in 17 low-income, middle-income and high-income countries

Objectives: This study examines in a cross-sectional study 'the tobacco control environment' including tobacco policy implementation and its association with quit ratio. Setting: 545 communities from 17 high-income, upper-middle, low-middle and low-income countries (HIC, UMIC, LMIC, LIC) i...

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Published in:BMJ Open
Main Author: Chow C.K.; Corsi D.J.; Gilmore A.B.; Kruger A.; Igumbor E.; Chifamba J.; Yang W.; Wei L.; Iqbal R.; Mony P.; Gupta R.; Vijayakumar K.; Mohan V.; Kumar R.; Rahman O.; Yusoff K.; Ismail N.; Zatonska K.; Altuntas Y.; Rosengren A.; Bahonar A.; Yusufali A.; Dagenais G.; Lear S.; DIaz R.; Avezum A.; Lopez-Jaramillo P.; Lanas F.; Rangarajan S.; Teo K.; McKee M.; Yusuf S.
Format: Review
Language:English
Published: BMJ Publishing Group 2017
Online Access:https://www.scopus.com/inward/record.uri?eid=2-s2.0-85016576076&doi=10.1136%2fbmjopen-2016-013817&partnerID=40&md5=8352a9692de76e6294baa528bef2c5be
id 2-s2.0-85016576076
spelling 2-s2.0-85016576076
Chow C.K.; Corsi D.J.; Gilmore A.B.; Kruger A.; Igumbor E.; Chifamba J.; Yang W.; Wei L.; Iqbal R.; Mony P.; Gupta R.; Vijayakumar K.; Mohan V.; Kumar R.; Rahman O.; Yusoff K.; Ismail N.; Zatonska K.; Altuntas Y.; Rosengren A.; Bahonar A.; Yusufali A.; Dagenais G.; Lear S.; DIaz R.; Avezum A.; Lopez-Jaramillo P.; Lanas F.; Rangarajan S.; Teo K.; McKee M.; Yusuf S.
Tobacco control environment: Cross-sectional survey of policy implementation, social unacceptability, knowledge of tobacco health harms and relationship to quit ratio in 17 low-income, middle-income and high-income countries
2017
BMJ Open
7
3
10.1136/bmjopen-2016-013817
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85016576076&doi=10.1136%2fbmjopen-2016-013817&partnerID=40&md5=8352a9692de76e6294baa528bef2c5be
Objectives: This study examines in a cross-sectional study 'the tobacco control environment' including tobacco policy implementation and its association with quit ratio. Setting: 545 communities from 17 high-income, upper-middle, low-middle and low-income countries (HIC, UMIC, LMIC, LIC) involved in the Environmental Profile of a Community's Health (EPOCH) study from 2009 to 2014. Participants: Community audits and surveys of adults (35-70 years, n=12 953). Primary and secondary outcome measures: Summary scores of tobacco policy implementation (cost and availability of cigarettes, tobacco advertising, antismoking signage), social unacceptability and knowledge were associated with quit ratios (former vs ever smokers) using multilevel logistic regression models. Results: Average tobacco control policy score was greater in communities from HIC. Overall 56.1% (306/545) of communities had <2 outlets selling cigarettes and in 28.6% (154/539) there was access to cheap cigarettes (<5cents/cigarette) (3.2% (3/93) in HIC, 0% UMIC, 52.6% (90/171) LMIC and 40.4% (61/151) in LIC). Effective bans (no tobacco advertisements) were in 63.0% (341/541) of communities (81.7% HIC, 52.8% UMIC, 65.1% LMIC and 57.6% LIC). In 70.4% (379/538) of communities, >80% of participants disapproved youth smoking (95.7% HIC, 57.6% UMIC, 76.3% LMIC and 58.9% LIC). The average knowledge score was >80% in 48.4% of communities (94.6% HIC, 53.6% UMIC, 31.8% LMIC and 35.1% LIC). communities in the highest quintile of the combined scores had 5.0 times the quit ratio in men (Odds ratio (OR) 5.0, 95% CI 3.4 to 7.4) and 4.1 times the quit ratio in women (OR 4.1, 95% CI 2.4 to 7.1). Conclusions: This study suggests that more focus is needed on ensuring the tobacco control policy is actually implemented, particularly in LMICs. The gender-related differences in associations of policy, social unacceptability and knowledge suggest that different strategies to promoting quitting may need to be implemented in men compared to women. © 2017 Chow CK, et al. BMJ Open.
BMJ Publishing Group
20446055
English
Review
All Open Access; Gold Open Access
author Chow C.K.; Corsi D.J.; Gilmore A.B.; Kruger A.; Igumbor E.; Chifamba J.; Yang W.; Wei L.; Iqbal R.; Mony P.; Gupta R.; Vijayakumar K.; Mohan V.; Kumar R.; Rahman O.; Yusoff K.; Ismail N.; Zatonska K.; Altuntas Y.; Rosengren A.; Bahonar A.; Yusufali A.; Dagenais G.; Lear S.; DIaz R.; Avezum A.; Lopez-Jaramillo P.; Lanas F.; Rangarajan S.; Teo K.; McKee M.; Yusuf S.
spellingShingle Chow C.K.; Corsi D.J.; Gilmore A.B.; Kruger A.; Igumbor E.; Chifamba J.; Yang W.; Wei L.; Iqbal R.; Mony P.; Gupta R.; Vijayakumar K.; Mohan V.; Kumar R.; Rahman O.; Yusoff K.; Ismail N.; Zatonska K.; Altuntas Y.; Rosengren A.; Bahonar A.; Yusufali A.; Dagenais G.; Lear S.; DIaz R.; Avezum A.; Lopez-Jaramillo P.; Lanas F.; Rangarajan S.; Teo K.; McKee M.; Yusuf S.
Tobacco control environment: Cross-sectional survey of policy implementation, social unacceptability, knowledge of tobacco health harms and relationship to quit ratio in 17 low-income, middle-income and high-income countries
author_facet Chow C.K.; Corsi D.J.; Gilmore A.B.; Kruger A.; Igumbor E.; Chifamba J.; Yang W.; Wei L.; Iqbal R.; Mony P.; Gupta R.; Vijayakumar K.; Mohan V.; Kumar R.; Rahman O.; Yusoff K.; Ismail N.; Zatonska K.; Altuntas Y.; Rosengren A.; Bahonar A.; Yusufali A.; Dagenais G.; Lear S.; DIaz R.; Avezum A.; Lopez-Jaramillo P.; Lanas F.; Rangarajan S.; Teo K.; McKee M.; Yusuf S.
author_sort Chow C.K.; Corsi D.J.; Gilmore A.B.; Kruger A.; Igumbor E.; Chifamba J.; Yang W.; Wei L.; Iqbal R.; Mony P.; Gupta R.; Vijayakumar K.; Mohan V.; Kumar R.; Rahman O.; Yusoff K.; Ismail N.; Zatonska K.; Altuntas Y.; Rosengren A.; Bahonar A.; Yusufali A.; Dagenais G.; Lear S.; DIaz R.; Avezum A.; Lopez-Jaramillo P.; Lanas F.; Rangarajan S.; Teo K.; McKee M.; Yusuf S.
title Tobacco control environment: Cross-sectional survey of policy implementation, social unacceptability, knowledge of tobacco health harms and relationship to quit ratio in 17 low-income, middle-income and high-income countries
title_short Tobacco control environment: Cross-sectional survey of policy implementation, social unacceptability, knowledge of tobacco health harms and relationship to quit ratio in 17 low-income, middle-income and high-income countries
title_full Tobacco control environment: Cross-sectional survey of policy implementation, social unacceptability, knowledge of tobacco health harms and relationship to quit ratio in 17 low-income, middle-income and high-income countries
title_fullStr Tobacco control environment: Cross-sectional survey of policy implementation, social unacceptability, knowledge of tobacco health harms and relationship to quit ratio in 17 low-income, middle-income and high-income countries
title_full_unstemmed Tobacco control environment: Cross-sectional survey of policy implementation, social unacceptability, knowledge of tobacco health harms and relationship to quit ratio in 17 low-income, middle-income and high-income countries
title_sort Tobacco control environment: Cross-sectional survey of policy implementation, social unacceptability, knowledge of tobacco health harms and relationship to quit ratio in 17 low-income, middle-income and high-income countries
publishDate 2017
container_title BMJ Open
container_volume 7
container_issue 3
doi_str_mv 10.1136/bmjopen-2016-013817
url https://www.scopus.com/inward/record.uri?eid=2-s2.0-85016576076&doi=10.1136%2fbmjopen-2016-013817&partnerID=40&md5=8352a9692de76e6294baa528bef2c5be
description Objectives: This study examines in a cross-sectional study 'the tobacco control environment' including tobacco policy implementation and its association with quit ratio. Setting: 545 communities from 17 high-income, upper-middle, low-middle and low-income countries (HIC, UMIC, LMIC, LIC) involved in the Environmental Profile of a Community's Health (EPOCH) study from 2009 to 2014. Participants: Community audits and surveys of adults (35-70 years, n=12 953). Primary and secondary outcome measures: Summary scores of tobacco policy implementation (cost and availability of cigarettes, tobacco advertising, antismoking signage), social unacceptability and knowledge were associated with quit ratios (former vs ever smokers) using multilevel logistic regression models. Results: Average tobacco control policy score was greater in communities from HIC. Overall 56.1% (306/545) of communities had <2 outlets selling cigarettes and in 28.6% (154/539) there was access to cheap cigarettes (<5cents/cigarette) (3.2% (3/93) in HIC, 0% UMIC, 52.6% (90/171) LMIC and 40.4% (61/151) in LIC). Effective bans (no tobacco advertisements) were in 63.0% (341/541) of communities (81.7% HIC, 52.8% UMIC, 65.1% LMIC and 57.6% LIC). In 70.4% (379/538) of communities, >80% of participants disapproved youth smoking (95.7% HIC, 57.6% UMIC, 76.3% LMIC and 58.9% LIC). The average knowledge score was >80% in 48.4% of communities (94.6% HIC, 53.6% UMIC, 31.8% LMIC and 35.1% LIC). communities in the highest quintile of the combined scores had 5.0 times the quit ratio in men (Odds ratio (OR) 5.0, 95% CI 3.4 to 7.4) and 4.1 times the quit ratio in women (OR 4.1, 95% CI 2.4 to 7.1). Conclusions: This study suggests that more focus is needed on ensuring the tobacco control policy is actually implemented, particularly in LMICs. The gender-related differences in associations of policy, social unacceptability and knowledge suggest that different strategies to promoting quitting may need to be implemented in men compared to women. © 2017 Chow CK, et al. BMJ Open.
publisher BMJ Publishing Group
issn 20446055
language English
format Review
accesstype All Open Access; Gold Open Access
record_format scopus
collection Scopus
_version_ 1798286510631419904

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