Smoking down, number of lives saved up as more countries embrace tobacco control measures

These conclusions, published online in Tobacco Control, updates their 2013 landmark study that found tobacco control measures undertaken by 41 countries between 2007-2010 had prevented 7.4 smoking-related million deaths.

"Our findings show the enormous and continuing potential to saving millions of lives by implementing tobacco control policies that have been proven to work," says lead author David Levy, PhD, professor of oncology at Georgetown Lombardi. "These new findings can help those countries -- more than half of the 196 total who have not yet undertaken life-saving tobacco control measures -- better understand the powerful public health impact they offer," he says.

This continuing analysis evaluates the mounting success of the World Health Organization's Framework Convention on Tobacco Control (WHO FCTC) by estimating deaths averted as a marker of policy impact. The WHO FCTC aims to reduce smoking by implementing evidence-based tobacco control measures. The convention came into force in 2005. As of January 1, 2015, 186 participating countries or entities (representing 95.8 percent of the world's population) have ratified the WHO FCTC. Ten remaining countries/entities do not participate, including the United States. At least 88 of the ratifying countries have adopted at least one of the measures to reduce smoking.

Known as "MPOWER," the measures of policy implementation, released in 2008, correspond to one or more of the demand reduction provisions included in the WHO FCTC: Monitoring tobacco use and prevention policies, Protecting people from tobacco smoke, Offering help to quit tobacco use, Warning people about the dangers of tobacco, Enforcing bans on tobacco advertising, Promotion and sponsorship, and Raising taxes on tobacco.

Georgetown investigators have employed their tobacco control model, SimSmoke, to calculate cigarette use and smoking-attributable deaths for individual countries.

Of the 22 million smoking attributable deaths averted in this new study, the researchers estimate that:

• 7 million were due to increased cigarette taxes,
• 5.4 million were due to smoke-free laws,
• 4.1 million were due to health warnings,
• 3.8 million were due to marketing bans, and
• 1.5 million were due to smoking cessation interventions.

Much of the increase in lives saved from smoking deaths took place between 2012 and 2014 due to implementation of tobacco control measures in three large countries with high smoking rates: Bangladesh (warnings, taxes), the Russian Federation (smoke-free air, advertising), and Vietnam (warnings). The new study also estimates that an additional 140 million lives can be saved if China, India and Indonesia adopt the WHO-FCTC measures.

"Brazil, Panama and Turkey have enacted all or most of the six MPOWER measures and have seen dramatic reductions in smoking prevalence," says Levy. To date, the U.S. has implemented only the FCTC-required cessation measures.