Monitoring and evaluation

Sustainable surveillance systems are essential for all countries and areas to monitor progress in tobacco control and its impact on the prevalence of the use of tobacco and related products over time. The WHO Framework Convention on Tobacco Control (FCTC) Article 20 requires its Parties to establish a national surveillance system to regularly collect national data on the magnitude, patterns, determinants and consequences of tobacco use and exposure. General information to support the Article 20 implementation is available on the WHO FCTC Knowledge Hub on Surveillance website.

Parties to the WHO FCTC are obligated to provide detailed reports every two years on the progress with the implementation of the treaty. The reports are an important source of data at national and global levels. Explore progress reports and country updates in the WHO FCTC implementation database. The WHO also tracks progress with the "best buys" under the MPOWER-assessment. It’s data is also publicly available at mpowerportal.org.

Further, the Sustainable Development Goals (SDGs) include a target 3.a which specifically calls for strengthening the implementation of the WHO FCTC, and its progress is monitored with a prevalence indicator. Countries are recommended to include this in the Voluntary National Reports (VNRs), and the WHO FCTC Secretariat has published a separate guide on this:
Guide for WHO FCTC Parties on including SDG Target 3.a in voluntary national reviews

Data collected for national and global monitoring of trends in tobacco use are important advocacy tools. They should be used for strengthening of national and international tobacco control policies.

Examples of tobacco endgame monitoring practices

When planning for the national monitoring and evaluation, it may be beneficial to familiarize with some of the examples on monitoring practices and key indicators in the European countries with existing tobacco endgame goals:

Recommendations for research

Upon synthesizing the research evidence as part of the work in the Work Package 9 of the JATC-2, the following specific recommendations for building evidence base and strengthening research on forward-looking tobacco control policies and tobacco endgame strategies have been formulated:

  • Establish and maintain a national surveillance system for monitoring tobacco and nicotine control in line with the Article 20 (Research, surveillance and exchange of information) of the WHO FCTC.
  • Designate a responsible entity for national monitoring (e.g., public health institute, statistical office, university department).
  • Define key indicators and target groups for regular monitoring, and whenever possible, ensure their comparability to other countries by aligning the definitions, age groups etc. with indicators and target groups used in the European region, especially in the EU.
  • Monitor changes in indicators, including among groups with vulnerabilities (e.g., children and adolescents, pregnant women) and high prevalence of tobacco or nicotine use.
  • Develop and maintain a reporting mechanism (e.g., statistical yearbook, online database) to facilitate the availability of national data for regulators, policymakers, and researchers.
  • Ensure that information and studies from manufacturers and importers are made publicly available in accordance with the provisions of Article 5 (para 4,6,7) and Article 20 (para 7,8,9) of the Tobacco Products Directive (2014/40/EU) to facilitate their use in research.
  • Supplement national language reports with English abstracts and key words to facilitate their identification as potential data sources for international research or comparisons.
  • Build collaboration with civil society, universities, and media to gain visibility for the research findings.
  • Promote research on tobacco endgame strategies and forward-looking tobacco control measures, especially on less studied measures such as supply-side policies.
  • Promote research on novel tobacco and nicotine products.
  • Promote research on the best buys of cessation programs (e.g., linking cessation counseling to screening, health promotion programs, etc.) and their integration to tobacco endgame strategies.
  • Support initiatives that facilitate research on tobacco endgame strategies and forward-looking tobacco control measures also in low-income countries, as there is little evidence on the feasibility and effectiveness of implementing endgame strategies at earlier stages of the tobacco epidemic.

When new policies or a new strategy is planned:

  • develop an evaluation plan which sets a timeline and responsibilities of different stakeholders
  • assess the need for additional indicators, data sources, and target groups
  • identify and document other parallel or recent policy changes that might influence the results (e.g., tax increases) and, if possible, collect data related to these
  • collect data on population support for key policy measures or strategy elements
  • aim for a comprehensive pre-evaluation and regulatory impact assessment (RIA) analysis utilizing national and international research on similar or related interventions, including modelling studies
  • compile information on relevant country experiences of full or partial implementation, especially in case scientific evidence is lacking
  • whenever possible, conduct both quantitative and qualitative research and assess the level of implementation and compliance with the policies
  • develop a sustainability plan considering all parameters (e.g. budget, staff, etc) that will contribute to the long-term continuation, monitoring and evaluation of a successful new policy or strategy for tobacco control policies and tobacco endgame strategies.

Be mindful of Article 5.3 of the WHO FCTC in research and tobacco control monitoring:

  • Do not engage in partnerships or other collaboration with tobacco industry or related entities with vested interests (e.g., front groups such as the Foundation for a Smoke-Free World/Global Action to End Smoking).
  • Do not accept funding or other resource support from these entities.
  • Do not allow representatives of these entities to be members in any publicly funded scientific or ethics committees, advisory groups or in other bodies that have a role in evaluation or regulatory impact assessment, and require a Declaration of Interest (DoI) statement in these positions.
  • When conducting research, evaluation, and regulatory impact assessment (RIA) analysis, build on robust peer-reviewed studies and refrain from the use of tobacco industry funded studies.
  • Identify and prepare for critical risk situations where the industry or related entities are likely to challenge the evidence by trying to interfere with policymaking.
  • When possible, document and monitor industry interference attempts in research and more widely, for instance in relation to circumventing bans on tobacco advertising, promotion and sponsorship, as this facilitates research on industry tactics and provides evidence of these activities at national and transnational level, helping policymaking and raising public awareness in line with the Article 12 of the WHO FCTC.

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