Tobacco control policies on cancer prevention in the Eastern Mediterranean Region, 2025–2050: A modeling study

by Saeed Nemati, Mojtaba Vand Rajabpour, Xiaoshuang Feng, Negar Taheri, Harriet Rumgay, Farrokh Heidari, Ebrahim Karimi, Sepideh Abdi, Mattias Johansson, Mahdi Sheikh Background Despite the implementation of control policies, smoking prevalence remains high in Eastern Mediterranean Region (EMR), and the impact of tobacco control efforts on cancer prevention is unclear. We assessed the potential impact of key policy interventions on tobacco-related cancer incidence in EMR countries from 2025 to 2050.

Methods and findings We conducted a modeling study using a country-level historical data to project tobacco smoking prevalence in EMR countries under four scenarios: (i) full implementation of the MPOWER (Monitor, Protection, Offer, Warn, Enforce, and Raise) policy package, (ii) a 10-unit increase in the cigarette affordability index (Higher values of the affordability index indicate that cigarettes are less affordable) (iii) maximized literacy rates (100% adult literacy), and (iv) combined implementation of all three policies. For each scenario, we estimated the Population Attributable Fraction (PAF) of tobacco smoking for 13 cancer types causally linked to tobacco use.