Impact of tobacco control policies on smoking prevalence and quit ratios in 27 European Union countries from 2006 - 2014
Ariadna Feliu 1, 2, 3  
Luk Joossens 4
Geoffrey T. Fong 6, 7
Constantine I. Vardavas 8, 9, 10
Yolanda Castellano 1, 2
Cristina Martinez 1, 2, 3
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Institut Català d'Oncologia, Tobacco Control Unit, WHO Collaborating Centre for Tobacco Control, Spain
Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, Cancer Prevention and Control Group, Spain
University of Barcelona, Departament of Clinical Sciences, School of Medicine, Campus Bellvitge, Spain
Association of European Cancer Leagues, Belgium
Imperial College London, Department of Primary Care and Public Health, School of Public Health, United Kingdom
University of Waterloo, Department of Psychology and School of Public Health and Health Systems, Canada
Ontario Institute for Cancer Research, Canada
University of Crete, Clinic of Social and Family Medicine, School of Medicine, Greece
National and Kapodistrian University of Athens, Center for Health Services Research, School of Medicine, Greece
European Network for Smoking and Tobacco Prevention - ENSP, Belgium
Publish date: 2018-03-01
Tob. Induc. Dis. 2018;16(Suppl 1):A20
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Smoking is still highly prevalent in Europe. According to the WHO, tobacco control policies vary substantially across countries. The Tobacco Control Scale (TCS) was developed to quantify the implementation of tobacco control policies at country level in Europe. The objective was to assess the impact of tobacco control policies (quantified by TCS scores) on smoking prevalence and quit ratios and their relative changes from 2006-2014 in 27 European Union (EU27) countries.

We conducted an ecological study at the country level. We used TCS scores in EU27 in 2007, and the prevalence of tobacco and quit ratios (No. ex-smokers/ No. ever smokers) data from the Eurobarometer surveys (2006 and 2014 waves). We analysed the relationship between the TCS scores and smoking prevalence and quit ratios and their relative changes by means of scatter plots, Spearman rank-correlation coefficients (rsp), and a multiple linear regression model adjusted for all TCS components.

In EU27, the smoking prevalence decreased by 14% (95%CI:7.3%-20.6%) (2006-2014) and varied from a relative decrease of 48.9% in Sweden to 0.4% in Bulgaria. The increase in the quit ratio in EU27 was 19.2% (95%CI:5.4%-33.1%) (2006-2014) and ranged from 125.8% in Sweden to 4.3% in Bulgaria. The correlation between TCS scores and smoking prevalence was negative (rsp=-0.444;p=0.02). A positive correlation was observed between TCS scores and quit ratios in 2014 (rsp=0.373;p=0.06) and in the relative changes in smoking prevalence (rsp=0.415;p=0.03). The percentage of smoking prevalence in 2014 explained by all TCS components in the regression model was 28.9%

European countries with higher TCS scores, which indicates higher tobacco control efforts, have lower prevalence of smokers, higher quit ratios, and higher relative decreases in their smoking prevalence over the last decade. Funding: EC Horizon2020 HCO-6-2015 (EUREST-PLUS No. 681109); Government of Spain & European Regional Development Fund (RTICC RD12/0036/0053); Government of Catalonia (2014SGR999).