How MPOWER-ed are we towards effective implementation of WHO FCTC?

Background and challenges to implementation Evaluation of national success on implementation of the WHO MPOWER package was lacking in Bangladesh until recently. In order to plan future work, it was important to gain an understanding of the advances and gaps in comprehensive tobacco control work. Intervention or response With support from The Union, Work for a Better Bangladesh (WBBT) carried out a six month long project on MPOWER implementation in Bangladesh. WBBT gathered background documents policy documents, and materials related to tobacco control that were printed by different organizations and discussed with various stakeholders through various national events. WBBT also carried out a series of key informant interviews with professionals working on tobacco control for several years, including staff of local- and national-level NGOs and officials of WHO. Results and lessons learnt We identified several gaps in MPOWER implementation, particularly in terms of monitoring, cessation, and taxation. Bangladesh still lacks a tax policy or specific guidelines. We found gaps in implementation of existing policy in terms of smoke-free places. While the law exists, there are significant gaps in its implementation. There are gaps in terms of law implementation on warnings. With a wide variety of tobacco products available, some of them with minimal packaging, a significant portion of tobacco products do not carry the mandated warnings. There are also weaknesses in terms of point of sale advertising. Conclusions and key recommendations For a country to be properly MPOWER-ed to tackle the tobacco epidemic, we must be aware of how far we have progressed and what significant gaps remain. Occasional survey on specific matter is not enough to give us an overall sense of where we are and where we need to be stronger. An MPOWER study can be conducted fairly easily by combining limited observation with a number of key informant interviews to arrive at a fairly accurate assessment of the MPOWER implementation situation