Projected preventable cancers through full implementation of tobacco control policies in East and South-East Asian countries, 2025–2050: a modeling study

Abstract

Summary Background To estimate the number of tobacco-related cancer cases that could be prevented if countries in East and South-East Asia achieved the highest level of implementation of the WHO MPOWER policy package (Monitor, Protect, Offer, Warn, Enforce, and Raise). Methods Based on data from Global Health Observatory and Global Cancer Observatory. We applied fixed-effects linear regression models to examine the association between changes in the national implementation of the MPOWER policies and tobacco smoking prevalence. Population Attributable Fractions (PAFs) for 13 tobacco-related cancers were calculated using Levin's formula under the scenarios of (i) continuation of the current trend, (ii) full implementation of MPOWER. The number of preventable cases (Potential Impact Fraction–PIF) was estimated using the difference in PAFs between the two scenarios. Findings Between 2025 and 2050, 159 million tobacco-related cancer cases were projected in East and South-East Asian countries, of which 44.2 million (PAF: 27.7%; 95% CI: 25.5–29.9) attributed to current tobacco smoking, including 41.6 million among men (PAF: 42.1%, 95% CI: 39.3–44.8) and 2.6 million among women (PAF: 4.3%, 95% CI: 3.0–5.7). Full implementation of MPOWER was estimated to prevent 3.5 million (95% CI: 2.9–4.0) cancers (PIF: 2.2%, 95% CI: 1.8–2.5). After adjusting for Human Development Index (HDI) variations, preventable cancers decreased to 2.2 million (PIF: 1.4%, 95% CI: 1.2–1.6). Interpretation Comprehensive implementation of MPOWER policies could substantially reduce the future cancer burden in East and South-East Asian countries. Funding None.