Are tobacco control policies effective? Interrupted time series analysis of routine tobacco surveillance ‎data: opportunities and challenges ‎
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ADIC-Ukraine, Ukraine
Publish date: 2019-03-26
Tob. Prev. Cessation 2019;5(Supplement):A13
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Tobacco control policies intend to impact long-term indicators of population health via ‎reducing the prevalence of tobacco use (POTU). Interrupted time series (ITS) analysis gives opportunities ‎in analyzing routinely collected longitudinal data to see the effects of interventions. ‎

ARIMA models were applied to routinely collected data on POTU in Ukraine. Dependent series ‎reflected POTU in 2000-2017 collected by the national statistics service. Independent series reflected the ‎adoption of tobacco control policies including tobacco taxation, smoke-free policies, and tobacco pack ‎health warnings. Independent variables had ordinal format to characterize the level of adopted policy and ‎binary format to denote the year of policy introduction.‎

All the considered population groups were responsive to tobacco taxation. POTU showed ‎delayed decreases next year after the new level of tobacco taxation was achieved. This POTU change per ‎average tax increase reached -1% for all, almost -2% for men and -0.4% for women. Sharp declines in ‎tobacco affordability caused immediate reactions of similar size in all groups which were more obvious in ‎men and more affluent groups. Introduction of new health warnings (stronger textual in late 2006 and ‎pictorials in 2012) caused immediate reactions more expressed among men and poorer population groups. ‎Smoke-free policies introduced in 2006 and 2012 did not reveal associated changes in POTU which could be ‎masked by contemporary policies.‎

ITS analysis of POTU data in Ukraine shows the predominant impact of tobacco taxation on ‎all population groups and the impact of health warnings on men and poorer smokers.‎