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However, this proxy also has some disadvantages for research purposes. In this sense, no previous research have examined the disparity between the implementation and enforcement of tobacco control policies; nevertheless, the TCS being predictive of so many outcomes suggests that the implementation of those insurance policies is an effective proxy of enforcement.

Other studies have used a total score obtained from summing the scores (from 1 to 5) assigned to each MPOWER policy dimension in the WHO’s Reports on the global Tobacco Epidemic40,41.