Revisiting the association between worldwide implementation of the MPOWER package and smoking prevalence, 2008-2017

Muhammad Jami Husain, Biplab Kumar Datta, Nigar Nargis, Roberto Iglesias, Anne Marie Perucic, Indu B. Ahluwalia, Angela Tripp, Sohani Fatehin, Muhammad Mudabbir Husain, Deliana Kostova, Patricia Richter

Research output: Contribution to journalReview articlepeer-review

19 Scopus citations


Background We revisited the association between progress in MPOWER implementation from 2008 to 2016 and smoking prevalence from 2009 to 2017 and offered an in-depth understanding of differential outcomes for various country groups. Methods We used data from six rounds of the WHO Reports on the Global Tobacco Epidemic and calculated a composite MPOWER Score for each country in each period. We categorised the countries in four initial conditions based on their tobacco control preparedness measured by MPOWER score in 2008 and smoking burden measured by age-adjusted adult daily smoking prevalence in 2006: (1) High MPOWER - high prevalence (HM-HP). (2) High MPOWER - low prevalence (HM-LP). (3) Low MPOWER - high prevalence (LM-HP). (4) Low MPOWER - low prevalence (LM-LP). We estimated the association of age-adjusted adult daily smoking prevalence with MPOWER Score and cigarette tax rates using two-way fixed-effects panel regression models including both year and country fixed effects. Results A unit increase of the MPOWER Score was associated with 0.39 and 0.50 percentage points decrease in adult daily smoking prevalence for HM-HP and HM-LP countries, respectively. When tax rate was controlled for separately from MPOWE, an increase in tax rate showed a negative association with daily smoking prevalence for HM-HP and LM-LP countries, while the MPOWE Score showed a negative association for all initial condition country groups except for LM-LP countries. Conclusion A decade after the introduction of the WHO MPOWER package, we observed that the countries with higher initial tobacco control preparedness and higher smoking burden were able to reduce the adult daily smoking prevalence significantly.

Original languageEnglish (US)
Pages (from-to)630-637
Number of pages8
JournalTobacco Control
Issue number6
StatePublished - Nov 1 2021
Externally publishedYes


  • Global tobacco epidemic
  • MPOWER Score
  • Smoking Prevalence
  • WHO MPOWER Measures
  • implementation of MPOWER package

ASJC Scopus subject areas

  • Health(social science)
  • Public Health, Environmental and Occupational Health


Dive into the research topics of 'Revisiting the association between worldwide implementation of the MPOWER package and smoking prevalence, 2008-2017'. Together they form a unique fingerprint.

Cite this