Evaluation of Five Data-to-Action Workshops to Enhance Capacity for Tobacco Control.

BACKGROUND: Five data-to-action workshops were conducted during 2016-2019 with participants from 38 countries. The purpose of the workshops is to use data to inform and disseminate tobacco prevention and control strategies. We evaluated the workshops using the Kirkpatrick Model for evaluation of trainings. METHODS: We evaluated the data-to-action workshops in three topic areas: (1) if the workshop was clear, useful, engaging, and relevant to the participant's work, (2) self-reported knowledge and skills for tobacco control topics, and (3) intention to apply the knowledge learned. We used nonparametric tests (one-sided Wilcoxon signed-rank test) and conducted descriptive analysis to assess the difference between pre- and postworkshop scores in each topic area. Free text data from open-ended responses were analyzed in Excel using thematic content analysis. RESULTS: Participants reported the workshop had a clear purpose (93.6%, n = 73), was well organized (94.9%, n = 74), and relevant to their work (96.2%, n = 76). There was a statistically significant increase in median learning scores across all three knowledge and five skills topic areas (p < 0.05); more than 95% of participants intended to apply the knowledge they obtained during the workshop and planned to perform new skills learned in the workshop. CONCLUSIONS: Programs interested in replicating a similar successful model may incorporate a mix of modes of instruction and hands-on experiences, as well as focus on the selection of the right audience, for their workshops. These workshops pose an opportunity for countries to enhance use and dissemination of their tobacco control data.

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

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.

Tobacco Smoking Cessation and Quitline Use Among Adults Aged ≥15 Years in 31 Countries: Findings From the Global Adult Tobacco Survey.

INTRODUCTION: About 80% of the 1.1 billion people who smoke tobacco worldwide reside in low- and middle-income countries. Evidence-based approaches to promote cessation include brief advice from health professionals and referrals through quitlines. This study assesses cessation behaviors and the use of cessation services in the past 12 months among current tobacco smokers in 31 countries who attempted to quit. METHODS: Data came from the Global Adult Tobacco Survey, a household-based survey of non-institutionalized adults aged ≥15 years. Surveys were conducted in 31 countries during 2008-2018; sample sizes ranged from 4,250 (Malaysia) to 74,037 (India), and response rates ranged from 64.4% (Ukraine) to 98.5% (Qatar). In 2019, data from the 31 countries were assessed in June 2019, and indicators included self-reported current (daily or less than daily) tobacco smoking, past-year quit attempts, and cessation methods used in the past 12 months. RESULTS: Current tobacco smoking prevalence ranged from 3.7% (Ethiopia) to 38.2% (Greece). Overall, an estimated 176.8 million adults from the 31 countries made a quit attempt in the past 12 months, with country-level prevalence ranging from 16.4% (Greece) to 54.7% (Botswana). Most individuals who made a quit attempt did so without assistance (median=74.4%). Other methods were less prevalent, including quitlines (median=0.2%) and counseling (median=7.2%). CONCLUSIONS: In the assessed countries, the majority of those who currently smoked tobacco and made a quit attempt did so without assistance; very few reported using quitlines, partly because of the lack of quitlines in some countries. In resource-limited settings, quitlines can play a greater role in helping people quit smoking as part of a comprehensive approach.