introduction: Health warnings on tobacco packages are an effective strategy for informing the public about the harms associated with tobacco use. Most studies investigating the effectiveness of pictorial health warnings (PHWs) on cigarette packages are from high-income countries. This study evaluated the impact of PHWs on smokers' perceptions and behavior in Mauritius, the first country in the World Health Organization African region to implement PHWs.
Background Mauritius has made great strides in adopting evidence-based tobacco control measures, including an increase in its cigarette excise tax and anti-tobacco mass media (Sponge) campaign. The primary objective of this study is to examine the combined effect of these measures on smoking behavior. Methods This study used longitudinal data from the International Tobacco Control Mauritius Survey, 2009–2011. Waves 1 and 2 were conducted before the tax increase and wave 3 was conducted shortly after the Sponge campaign and six months after the cigarette excise tax increase. Generalized estimating equations were used to examine the effects of these two key tobacco control measures on smoking prevalence and the quantity of cigarettes smoked. Results The results showed that the combination of cigarette tax increase and the Sponge campaign had a significant negative effect on the prevalence of smoking in Mauritius and the number of cigarettes smoked among continuing smokers. Specifically, the measures significantly reduced the odds of being a smoker (AOR 0.88, 95% CI 0.81–0.97). For average daily cigarettes smoked, the measures had a significant reduction in cigarettes per day by about 6% (Incidence-rate ratios 0.94, 95% CI 0.89–0.99). Conclusions The combination of policy measures significantly reduced the consumption of cigarettes in Mauritius. While these results are encouraging, these efforts must be part of a sustained effort to further reduce the smoking prevalence in Mauritius.
INTRODUCTION Mauritius has one of the highest rates of smoking in Africa. Smoking cessation is a priority for preventing tobacco-related morbidity and mortality. The purpose of this study is to identify the predictors of quit intentions among smokers in Mauritius in order to strengthen tobacco control policies and inform the development and delivery of services that may increase the likelihood of successful quitting. METHODS Data were drawn from Wave 1 (2009) of the International Tobacco Control (ITC) Mauritius Survey, a face-to-face cohort survey of a nationally representative sample of 598 adult smokers who were randomly selected from nine geographic districts in Mauritius using a multistage sampling procedure. RESULTS The vast majority of smokers (77.8%) had plans to quit smoking. Longer duration of past quit attempts (6 months or less), perceiving benefits of quitting, worrying about smoking damaging health in the future, and not enjoying smoking were significantly associated with quit intentions. However, socio-demographic characteristics, past quit attempts, overall attitude about smoking, and Heaviness of Smoking Index (HSI) were not associated with quit intentions. CONCLUSIONS The predictors of quit intentions among Mauritian smokers were generally similar to those found among smokers in other high-and middle-income countries. However, in contrast to findings in those other countries, nicotine dependence as measured by the HSI was not a significant predictor of quit intentions among Mauritian smokers. These findings highlight the need to consider the predictors of quit intentions when developing and delivering smoking cessation support services in Mauritius.
Background: The objectives of the study reported in this paper were: (a) to score the coverage of core NCD population-based interventions and individual services in Mauritius; (b) to analyse and score the presence of 15 common health system challenges that impede delivery of core NCD interventions and services in Mauritius; and (c) to provide policy recommendations for Mauritius to address health system barriers to delivery of NCD interventions and services. Methods: The Mauritius country assessment applied the guidelines developed by the World Health Organization Regional Office for Europe for systematically scoring coverage of NCD interventions and assessing health system challenges for improving NCD outcomes. The assessment used qualitative research design approach. Results: Of the 24 core population-based interventions for addressing key NCD risk factors, 16.7% were rated extensive, 37.5% moderate and 45.8% limited. Three (20%), 8 (53%) and 4 (27%) of the 15 individual/personal CVD, diabetes and cancer services were rated extensive, moderate and limited respectively. The top five health system challenges hampering scale-up of coverage of population-based NCD interventions in Mauritius were inadequate interagency cooperation; limited application of explicit priority setting approaches; inadequate change management; sub-optimal distribution and mix human resources; insufficient population empowerment; and insufficient political commitment. The top five challenges had average scores of between 3.1 (interagency cooperation) and 2.4 (distribution and mix of human resources). The top five health system challenges constraining expansion in coverage of individual NCD services were limited integration of evidence into practice; limited use of explicit priority-setting approaches; inadequate application of information and technology solutions; insufficient population empowerment; and sub-optimal distribution and mix of human resources. The top five challenges for individual interventions had mean scores varying between 2.6 (integration of evidence into practice) and 1.7 (distribution and mix of human resources).Conclusions: Mauritius needs to increase its domestic general government investments into the national health system and requisite multi-sectoral action to address the priority health system challenges with a view of bridging the existing gaps in coverage of NCD population-based interventions and individual services.
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