Tobacco endgame in the WHO European Region: Feasibility in light of current tobacco control status.

To assess the feasibility of developing World Health Organization (WHO) European Region countries' goals and measures in line with tobacco endgame objectives, information on the current tobacco control context and capacity is needed. The aim of this study was to assess the implementation of the Framework Convention on Tobacco Control (WHO FCTC) and MPOWER measures in the region. In this cross-sectional study we used data from the WHO FCTC implementation reports and MPOWER from 2020 in 53 WHO European Region countries. Six domains (i.e. capacity, taxation and price policies, other national key regulations, public awareness raising and communication, tobacco use cessation, and monitoring) were formed. Subsequently, available indicators under these domains were scored and the level of implementation was computed for each country. Mann-Whitney tests were carried out to compare the scores between the group of countries with and without official endgame goals. Overall, implementation of the WHO FCTC with the selected indicators at the country level ranged from 28% to 86%, and of MPOWER from 31% to 96%. Full implementation was achieved by 28% of WHO FCTC Parties in the region in taxation and price policies, 12% in public awareness raising and communication, and 42% in monitoring. In capacity, tobacco use cessation and other national key regulations, none of the Parties in the region reached full implementation. Overall median WHO FCTC scores were significantly higher in countries with official endgame goals than in those without (p<0.001). There is unequal implementation of both WHO FCTC and MPOWER measures among WHO European Region countries. MPOWER and WHO FCTC provide all the measures for the necessary first steps, followed by innovative measures, to accomplish tobacco endgame goals.

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© 2023 González-Marrón A. et al.

Déclaration de conflit d'intérêts

The authors have each completed and submitted an ICMJE form for Disclosure of Potential Conflicts of Interest. The authors declare that they have no competing interests, financial or otherwise, related to the current work. A. González Marrón, C. Lidón-Moyano, H. Pérez-Martín, O. Ruokolainen, T. Laatikainen and H. Ollila, report that since the initial planning of the work received support by the European Union’s Health Program (2014-2020) under grant agreement N°101035968. H. Koprivnikar, J. Tisza, Z. Cselkó, A. Lambrou, E. Papachristou, M. Vasic, R. Guignard, S. Schoretsaniti and V. Nguyen-Thanh report that since the initial planning of the work their institution received support by European Commission for the Joint action on tobacco control 2 (JATC 2). In addition, M. Mulcahy reports that since the initial planning of the work he received support from the Health Service Executive, Ireland and the Joint action on tobacco control 2 (JATC 2). He also reports that in the past 36 months he received grants, consulting fees, support for attending meetings and travels and receipt of equipment/ materials from the Health Service Executive, Ireland and the Joint action on tobacco control 2 (JATC 2). H. Koprivnikar reports that in the past 36 months she received payment from the Medical Faculty, University of Ljubljana, for lecture to pediatric residents and from Slovene Medical Chamber for lecture to health professionals. E. Nunes reports that since the initial planing of the work she received support from European Commission and from General Directorate of Health, Ministry of Health, Portugal. M. Karekla reports that since the initial planning of the work she received support from Horizon Europe (no payments made to her or her institution). She also reports that in the past 36 months she received support from Horizon Europe for attending meetings of this group and that she is the immediate past president of the Association for Contextual Behavior Science. R. Guignard and V. Nguyen-Thanh report that in past 36 months they received support from the European Commission for travel and accommodation to the JATC 2 consortium meeting in Madrid, Spain, in April 2023.