约克大学Steven J Hoffman团队近日取得一项新成果。他们研究了《世界卫生组织烟草控制框架公约》对全球烟草消费的影响：使用中断时间序列分析（ITS）和样本内预测事件模型两种准实验评估。 该研究于2019年6月19日发表于国际一流学术期刊《英国医学杂志》杂志上。

研究者评估了《世界卫生组织烟草控制框架公约》对全球烟草消费的影响。研究者通过使用ITS或事件模型两种不同评估方法，对1970年至2015年，71个国家的成年烟草消费量进行估算（这些国家占世界烟草消费量的95%以上，占世界人口的85%）。研究发现：2003年《烟草控制框架公约》（FCTC）通过后，全球烟草消费量的下降速度没有发生显著变化。重新调整数据至“FCTC”谈判开始年份（1999年）或“FCTC”首次在各个国家具有法律约束力的年份开始评估，结果显示变化显著。与全球烟草消费相比，2003年后，高收入和欧洲国家的成人每年人均烟草消费量下降了1000支。然而与反事实推断模型对比，中低收入和亚洲各国成人每年人均烟草消费量则是增加了500多支。研究者建议：考虑到区域差异性原因，全球烟草控制委员会要严防自满，在烟草控制政策实行上要更加积极，对烟草企业活动应该给予更加坚定的回应，传导更加有效的健康治疗方案。

每年烟草导致约七百万的死亡和近5000亿美元(￡3960亿;价值4490亿欧元)的经济损失，原因是超额的医疗护理系统损耗和生产力损失。研究人员表示，烟草消费是全球可预防性死亡的主要原因之一。

附：英文原文

Title: Impact of the WHO Framework Convention on Tobacco Control on global cigarette consumption: quasi-experimental evaluations using interrupted time series analysis and in-sample forecast event modelling

Author: Steven J Hoffman, professor,  Mathieu J P Poirier, assistant professor,  Susan Rogers Van Katwyk, managing research fellow,  Prativa Baral, research fellow,  Lathika Sritharan, research manager

Issue&Volume: vol 365, issue 8204,2019

Abstract: 

Objective To evaluate the impact of the WHO Framework Convention on Tobacco Control (FCTC) on global cigarette consumption.

Design Two quasi-experimental impact evaluations, using interrupted time series analysis (ITS) and in-sample forecast event modelling.

Setting and population 71 countries for which verified national estimates of cigarette consumption from 1970 to 2015 were available, representing over 95% of the world’s cigarette consumption and 85% of the world’s population.

Main outcome measures The FCTC is an international treaty adopted in 2003 that aims to reduce harmful tobacco consumption and is legally binding on the 181 countries that have ratified it. Main outcomes were annual national estimates of cigarette consumption per adult from 71 countries since 1970, allowing global, regional, and country comparisons of consumption levels and trends before and after 2003, with counterfactual control groups modelled using pre-intervention linear time trends (for ITS) and in-sample forecasts (for event modelling).

Results No significant change was found in the rate at which global cigarette consumption had been decreasing after the FCTC’s adoption in 2003, using either ITS or event modelling. Results were robust after realigning data to the year FCTC negotiations commenced (1999), or to the year when the FCTC first became legally binding in each country. By contrast to global consumption, high income and European countries showed a decrease in annual consumption by over 1000 cigarettes per adult after 2003, whereas low and middle income and Asian countries showed an increased annual consumption by over 500 cigarettes per adult when compared with a counterfactual event model.

Conclusions This study finds no evidence to indicate that global progress in reducing cigarette consumption has been accelerated by the FCTC treaty mechanism. This null finding, combined with regional differences, should caution against complacency in the global tobacco control community, motivate greater implementation of proven tobacco control policies, encourage assertive responses to tobacco industry activities, and inform the design of more effective health treaties.

DOI: https://doi.org/10.1136/bmj.l2287

Source: https://www.bmj.com/content/365/bmj.l2287