Journal of Preventive Medicine and Public Health

Perspective

Epidemiological Model for Conventional Tobacco Control Measures and Tobacco Endgame Policies: Heewon Kang, Sung-il Cho; J Prev Med Public Health. 2023;56(5):481-484. Published online September 26, 2023; DOI: https://doi.org/10.3961/jpmph.23.239

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Abstract Summary PDF Supplementary Material

Epidemiological models, also known as host-agent-vector-environment models, are utilized in public health to gain insights into disease occurrence and to formulate intervention strategies. In this paper, we propose an epidemiological model that incorporates both conventional measures and tobacco endgame policies. Our model suggests that conventional measures focus on relationships among agent-vector-host-environment components, whereas endgame policies inherently aim to change or eliminate those components at a fundamental level. We also found that the vector (tobacco industry) and environment (physical and social surroundings) components were insufficiently researched or controlled by both conventional measures and tobacco endgame policies. The use of an epidemiological model for tobacco control and the tobacco endgame is recommended to identify areas that require greater effort and to develop effective intervention measures.

Summary

Korean summary
이 연구는 기존의 담배규제와 관련된 역학 모형을 확장하여 담배 수요를 줄이기 위한 조치인 MPOWER 정책과 담배 종결전의 주요 정책을 아우르는 개념적 모형을 제시하였다. 각 정책을 개념적 모형 내 배치한 결과, MPOWER 정책은 모형 내 구성요소 간의 연결을 끊는 것을 목표로 하는 반면, 종결전 정책은 모형 내 요소들을 영구적으로 변화시키거나 제거하려는 특성을 가지고 있는 것으로 나타났다. 담배규제정책이 개체, 병원체, 벡터 및 환경 요소에 대한 균형 잡힌 포트폴리오를 갖추고 있는지 평가하기 위해 이 개념적 모형을 활용할 수 있다.

Key Message
We extended the conceptual epidemiological model for tobacco control by incorporating measures to reduce the demand for tobacco (MPOWER measures) and key endgame policies. The model suggests that MPOWER measures focus on disconnecting the relationships between model components, while endgame policies aim to permanently change or eliminate the components themselves. This model can be used to examine whether a country or jurisdiction's tobacco control policy maintains a balanced portfolio across agent, host, vector, and environmental factors.

Citations

Citations to this article as recorded by

Public support for tobacco endgame policies in South Korea: Findings from the 2020 International Tobacco Control Korea Survey
Heewon Kang, Wonjeong Yoon, Hong Gwan Seo, Sungkyu Lee, Sujin Lim, Gil-yong Kim, Su Young Kim, Steve S Xu, Mi Yan, Anne C K Quah, Janet Chung-Hall, Lorraine V Craig, Coral E Gartner, Geoffrey T Fong, Sung-il Cho
Tobacco Control.2024; : tc-2023-058454. CrossRef
Decrease in household secondhand smoking among South Korean adolescents associated with smoke-free policies: grade-period-cohort and interrupted time series analyses
Hana Kim, Heewon Kang, Sung-il Cho
Epidemiology and Health.2023; : e2024009. CrossRef

Original Article

Tobacco Control Stakeholder Perspectives on the Future of Tobacco Marketing Regulation in Indonesia: A Modified Delphi Study: Putu Ayu Swandewi Astuti, Mary Assunta, Becky Freeman; J Prev Med Public Health. 2021;54(5):330-339. Published online August 26, 2021; DOI: https://doi.org/10.3961/jpmph.21.181

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Abstract PDF Supplementary Material

Objectives
Tobacco control in Indonesia is very lenient compared to international standards. This study explored the perspectives of tobacco control stakeholders (TCSs) on the likelihood of advancing tobacco marketing regulation in Indonesia.
Methods
Data were collected from TCSs who were members of the Indonesia Tobacco Control Network group in a modified Delphi study. We collected the data in 2 waves using a questionnaire that comprised a set of closed and open-ended questions. For this paper, we analysed 2 of the 3 sections of the questionnaire: (1) tobacco advertising, promotions, and sponsorship (TAPS) bans, and (2) marketing and retailing regulations. We conducted a descriptive analysis of the scores using Stata/IC.13 and summarised the comments for each item.
Results
The TCSs viewed the measures/strategies across all aspects of TAPS and tobacco marketing regulation as highly desirable, but provided varied responses on their feasibility. They rated political feasibility lower than technical feasibility for most measures. Advancing TAPS measures and prohibition of selling to minors were considered more attainable by sub-national governments, while prohibition of tobacco corporate social responsibility was considered as the least feasible measure in the next 5 years.
Conclusions
Despite little optimism for substantial national-level change, there is a positive expectation that sub-national governments will strengthen their tobacco control regulation. It is paramount that the government reduce tobacco industry leverage by implementing Article 5.3 of the World Health Organization Framework Convention on Tobacco Control. Extending advocacy networks beyond tobacco control groups and framing tobacco control more effectively are necessary steps.

Summary

Citations

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Tobacco policy (in)coherence in Mozambique: an examination of national and subnational stakeholder perspectives
Nicole Nguenha, Charo Rodriguez, Jeffrey Drope, Stella Aguinaga Bialous, Benedito Cunguara, Raphael Lencucha
Health Policy and Planning.2024; 39(4): 333. CrossRef
Achieving a tobacco-free Bangladesh by 2040: a qualitative analysis of the tobacco advertising environment and prohibitions in Bangladesh
Arsenios Tselengidis, Sally Adams, Becky Freeman, Syed Mahbubul Alam, Putu Ayu Swandewi Astuti, Jo Cranwell
BMJ Open.2023; 13(5): e069620. CrossRef

Brief Report

Monitoring Compliance and Examining Challenges of a Smoke-free Policy in Jayapura, Indonesia: Wahyuti Wahyuti, Suci Hasairin, Sherly Mamoribo, Abdillah Ahsan, Dian Kusuma; J Prev Med Public Health. 2019;52(6):427-432. Published online November 22, 2019; DOI: https://doi.org/10.3961/jpmph.19.240

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Abstract PDF

Background
In Indonesia, 61 million adults smoked in 2018 and 59 million were exposed to secondhand smoke at offices or restaurants in 2011. The Presidential Decree 109/2012 encouraged local governments to implement smoke-free policy (SFP) with Jayapura city enacted a local bill (1/2015) in 2015. Objective: This study aims to evaluate the compliance and explore the challenges in implementing. Methods: We conducted a mixed-methods study. The quantitative method assessed the compliance to six criteria (as per the bill) including having signage, no smoking activity, no selling, no advertisement, no smoke, and no ashtray at SFP facilities. We surveyed 192 facilities including health facilities, educational facilities, places of worship, government offices, and indoor/outdoor public facilities. The qualitative method explored challenges in implementing through by interviewing 19 informants (government officers, students and community). Results: The compliance rate to all six criteria was 17% overall, ranging from 0% at outdoor public facilities to 50% at health facilities. We found no spatial patterning as shown by similar compliance rates between SFP facilities within and outside of 1-kilometer around the provincial and city health offices. Implementation challenges included (a) limited budget for enforcement, (b) lack of support from local non-government organizations and universities, (c) lack of public awareness at facilities, and (c) lack of examples from local leaders. Conclusion: The overall compliance was low in Jayapura city due to many challenges. This provides lessons learnt for tobacco control policy in the areas that are least developed and farthest from the central government.

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Jacqueline A. Teed, Meagan O. Robichaud, Michelle Duren, Hebe N. Gouda, Ryan David Kennedy
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BMJ Open.2023; 13(12): e072312. CrossRef
Decrease in household secondhand smoking among South Korean adolescents associated with smoke-free policies: grade-period-cohort and interrupted time series analyses
Hana Kim, Heewon Kang, Sung-il Cho
Epidemiology and Health.2023; : e2024009. CrossRef
Compliance With Tobacco Control Policy and Visibility of Cigarette Retailers Around Educational Facilities in Riyadh, Saudi Arabia
Hala AlJishi, Dian Kusuma, Alaa AlQurashi, Ali AlFaiz, Abdulaziz AlSaad, Maha Aljishi
Frontiers in Public Health.2022;[Epub] CrossRef
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Faizal Rahmanto Moeis, Renny Nurhasana, Fandy Rahardi, Danty Novitasari, Ni Made Shellasih, Inayati, Murwendah, Paibul Suriyawongpaisal, Roengrudee Patanavanich, Suci Puspita Ratih
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Bambang Priyono, Balqis Hafidhah, Wihardini Wihardini, Ramadhani Nuryunawati, Fathi Rahmadi, Dian Kusuma
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Review

Cancer Control Programs in East Asia: Evidence From the International Literature: Malcolm A. Moore; J Prev Med Public Health. 2014;47(4):183-200. Published online July 31, 2014; DOI: https://doi.org/10.3961/jpmph.2014.47.4.183

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Abstract PDF

Cancer is a major cause of mortality and morbidity throughout the world, including the countries of North-East and South-East Asia. Assessment of burden through cancer registration, determination of risk and protective factors, early detection and screening, clinical practice, interventions for example in vaccination, tobacco cessation efforts and palliative care all should be included in comprehensive cancer control programs. The degree to which this is possible naturally depends on the resources available at local, national and international levels. The present review concerns elements of cancer control programs established in China, Taiwan, Korea, and Japan in North-East Asia, Viet Nam, Thailand, Malaysia, and Indonesia as representative larger countries of South-East Asia for comparison, using the published literature as a guide. While major advances have been made, there are still areas which need more attention, especially in South-East Asia, and international cooperation is essential if standard guidelines are to be generated to allow effective cancer control efforts throughout the Far East.

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