ArticleBMJ open2017
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.
Article in BMJ open, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03225586 (Prospective Urban Rural Epidemiology Study), which is not on this map. Cited by 40 papers, 4 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Prospective Urban Rural Epidemiology Study
Who cites it
40 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- A systematic review and network meta-analysis of population-level interventions to tackle smoking behaviour.Nature human behaviour · 2024Pooled it
- The global estimate of premature cardiovascular mortality: a systematic review and meta-analysis of age-standardized mortality rate.BMC public health · 2023Pooled it
- The burden of premature mortality from cardiovascular diseases: A systematic review of years of life lost.PloS one · 2023Pooled it
- Technology-Based Substance Use Interventions: Opportunities for Gender-Transformative Health Promotion.International journal of environmental research and public health · 2020Pooled it
- Trial
- Trial
- The policy implementation playbook: a cross-policy taxonomy of post-adoption tobacco industry tactics.Globalization and health · 2026Review
- Density of tobacco retail outlets around school in Lao People's Democratic Republic 2024: a geospatial analysis.Frontiers in epidemiology · 2026Article
- Bridging the gap between policy and practice: a mixed-methods study of tobacco control implementation challenges and community responses in Hyderabad, Sindh, Pakistan.Frontiers in public health · 2026Article
- Tobacco retail characteristics across urban and rural districts in Lao PDR: an observational study, 2024.Frontiers in public health · 2026Observational
- Cross-country health inequality in the asthma burden: findings from the global burden of disease study 2021.BMC public health · 2025Article
- Social factors, health policy, and environment: implications for cardiovascular disease across the globe.European heart journal · 2025Review
- Quick buys for prevention and control of noncommunicable diseases.The Lancet regional health. Europe · 2025Review
- Assessing the built environment through photographs and its association with obesity in 21 countries: the PURE Study.The Lancet. Global health · 2024Article
- Tobacco use and risk of acute stroke in 32 countries in the INTERSTROKE study: a case-control study.EClinicalMedicine · 2024Article
- Global patterns of asthma burden related to environmental risk factors during 1990-2019: an age-period-cohort analysis for global burden of disease study 2019.Environmental health : a global access science source · 2024Article
- Review
- Premature Death, Underlying Reasons, and Preventive Experiences in Iran: A Narrative Review.Archives of Iranian medicine · 2023Review
- Addressing global disparities in blood pressure control: perspectives of the International Society of Hypertension.Cardiovascular research · 2023Article
- Disparities in thoracic surgical oncology.Journal of surgical oncology · 2023Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
32 authors.
Funding
Abstract
objectivesThis study examines in a cross-sectional study 'the tobacco control environment' including tobacco policy implementation and its association with quit ratio.
setting545 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.
participantsCommunity 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.
resultsAverage 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). Summary scores of policy implementation, social unacceptability and knowledge were positively and significantly associated with quit ratio and the associations varied by gender, for example, 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).
conclusionsThis 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.
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Registered trials
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