Democracy, gender equality, advanced civil rights, economic welfare, and equitable distribution of wealth are related to the success of tobacco control

INTRODUCTION: It is well known that there are many social and economic factors influencing tobacco use. There are very few studies addressing these aspects of the issue. Nevertheless, smoking is closely related to social, economic, cultural, and political factors. This study aims to present the aspects of the MPOWER application that should be expanded in order to achieve a more effective tobacco control policy. METHODS: Thirty-one countries were included in this secondary data analysis. The smoking prevalence of the countries in 2020 and the changes in smoking prevalence between 2010 and 2020 were taken as dependent variables. Criteria indicating the level of development, democratic standards, gender equality, civil rights, and basic health level of the countries were considered independent variables. Pearson (r) or Spearman (ρ) correlation analyses were conducted based on normality assumptions. RESULTS: There was a positive linear correlation between smoking prevalence and the total unemployment rate (ρ=0.78), income inequality (ρ=0.72), the Global Rights Index (ρ=0.54), and the Gender Inequality Index (ρ=0.45). In contrast, smoking prevalence was negatively correlated with current health expenditures (ρ= -0.55), the Human Development Index (ρ= -0.55), the Corruption Perceptions Index (r= -0.51), the World Justice Index (ρ= -0.47), the share of seats in parliament (r= -0.43), the Democracy Index (ρ= -0.41), and MPOWER (2008) (ρ= -0.38). There was a strong positive correlation between the percent change in smoking prevalence and income inequality (ρ=0.77), the total unemployment rate (ρ=0.64), the Gender Inequality Index (ρ=0.46), and the Global Rights Index (ρ=0.44). Conversely, the percent change in smoking prevalence was negatively correlated with the Freedom Index (ρ= -0.67), the Democracy Index (ρ= -0.67), the Human Development Index (ρ= -0.59), the Corruption Perceptions Index (r= -0.56), current health expenditure (ρ= -0.55), GDP per capita (ρ= -0.53), and MPOWER (2008) (ρ= -0.47). CONCLUSIONS: Besides the MPOWER application, factors correlated with the success of tobacco control are social determinants of health, gender equality, and advanced democracy.