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Background: In 2008, the World Health Organization (WHO) introduced a package of measures including 6 main policies (MPOWER) to control tobacco use., Aims: This study aimed to perform a quantitative analysis of MPOWER in the WHO regions., Methods: This cross-sectional study collected information in summer 2018 using pages 136-149 of the 2017 MPOWER report and a validated check list with 10 criteria, with a possible maximum score of 37. The scores were summed and presented in descending order for the 6 WHO regions., Results: The highest mean score was recorded by the European Region (26.41), followed by: South-East Asia Region (25), Western Pacific Region (24.88), Region of the Americas (22.05), Eastern Mediterranean Region (21.40) and African Region (17.40). There were significant differences (P < 0.05) in the means., Conclusions: Although many efforts have been made in the Eastern Mediterranean Region, many challenges to policy implementation and enforcement remain compared with other regions, and require urgent action by governments in the Region., (Copyright © World Health Organization (WHO) 2020. Open Access. Some rights reserved. This work is available under the CC BY-NC-SA 3.0 IGO license (https://creativecommons.org/licenses/by-nc-sa/3.0/igo).)

This study was conducted to quantify the implementation of the MPOWER policies and to assess any possible changes across Eastern Mediterranean Region (EMR) countries. In this comparative cross-sectional study based on 10 categories mentioned in MPOWER report 2015 a checklist was designed. Seven questions were scored from 0-4 and three from 0-3. The 22 EMR countries were ranked and compared by their total score on a scale of 0-37. The highest scores were achieved by Egypt and the Islamic Republic of Iran. Pakistan, Sudan and Yemen showed progress, while Bahrain, Jordan, Kuwait, Oman, and the Syrian Arab Republic had decreased scores. The total score of the EMR countries had decreased compared to 2013. Thus, there remains a need for greater focus on tobacco taxation and smoke-free policies to address this retrograde step.

We conducted in-depth interviews with key tobacco control policy-makers to explore their views and opinions of trends in tobacco use and the effectiveness of tobacco control programmes over the past 3 decades. A qualitative interview study was conducted in 2014 using a grounded theory approach. In-depth interviews were conducted with 86 key tobacco control policy-makers and data collection was based on principles of saturation. The core code "tobacco consumption and its control programme" was extracted and its related themes were listed. After review and classification by an expert panel, 9 categorized codes emerged. The final 31 codes were ordered according to their conceptual differentiations. Overall, tobacco consumption was constant over the past 3 decades; however it was increasing in females and young people and decreasing in older people; hookah consumption was increasing. A positive outcome is that tobacco use is now viewed negatively in the Islamic Republic of Iran, largely due to tobacco control programmes but the current situation is still not ideal and a comprehensive tobacco control law is needed.

Backgrond: Following MPOWER's 2011 report, a study was conducted to quantify the implementation of MPOWER tobacco control policies in the Eastern Mediterranean Region (EMR) in 2013 to assess any possible change during the last two years. , Methods: In this cross sectional study, based on 10 categories mentioned in MPOWER 2013, a checklist was designed and its scoring was agreed upon by Iranian and international tobacco control specialists. Seven questions were scored from 0 - 4 and 3 from 0 - 3. The 22 countries were ranked by their total score on a scale of 0 to 37. , Results: Among the 22 countries in the EMR, Iran, Kuwait, Egypt, Lebanon, Gaza and West bank and Jordan were scored 31, 28, 28, 26, 25 and 25 respectively. 14 countries scored more than 50%, a small improvement; 5 countries have seen their scores fall, and three countries received the same score as last time. The highest overall improvement was attributed to the warning label, and the sharpest decline was observed in the consumption category., Conclusion: There has been a slight overall improvement in tobacco control planning, although the desired levels have yet to be reached and some countries in the region have fared worse.