Consequently, the mentioned evaluation indices are mainly related to the performance of policy-makers. Nevertheless, considering the role of stakeholders in tobacco industry, measures taken by the government may fail without improving the stakeholders’ knowledge, attitude, and performance along with reducing their benefits. For instance, the emergency plan of the government to collect hookahs faced the vast opposition of teashop owners. Creating employment is an issue of high priority
to the Iranian government Inhibitors,research,lifescience,medical and a factor of crucial significance in the implementation of the NCTCP. One of the indicators that emerged from the interviews was the creation of alternative employment opportunities Inhibitors,research,lifescience,medical for people whose livelihoods are associated with tobacco production, supply, and distribution. Another important Rigosertib solubility dmso indicator is the control of tobacco smuggling. Annually, 60 billion cigarettes are smoked in Iran.9 One-third of these cigarettes are smuggled.10 Policies and strategies concerning tobacco smuggling can influence the accessibility of tobacco products. As is shown in table 3, the community attitudes can reduce the demand for tobacco and it is as an essential indicator to tobacco control. The community’s perception of tobacco control policies can influence the implementation and outcome of such policies; hence, an understanding
of the social context where tobacco control policies are to be put into action is an essential component Inhibitors,research,lifescience,medical of models for the implementation and evaluation of tobacco control programs.11,12 Similar to ITC evaluation indicator,13 impact and outcome indicators are the important indicators at the community level. Community knowledge, attitude, and practice are the impact indicators. Inhibitors,research,lifescience,medical The frequency of quitting tobacco and undergoing withdrawal treatment, the incidence of tobacco-related diseases, morbidity and mortality, and people’s
quality of life are examples Inhibitors,research,lifescience,medical of outcome indicators. One of the major problems in Iran and other Middle Eastern countries is hookah smoking as a recreational activity. Therefore, if the public attitude toward hookah smoking does not change, implementing the rule of banning the hookah and removing it from teahouses will be difficult. Therefore, the number of teahouses offering hookahs is an important indicator for evaluating the changes occurring in the stakeholders’ not domain. The KAP of parents and their children toward hookah and the prevalence of hookah smoking in the general population, are important impact and outcome indicators for evaluating the implementation of the NCTCP. Conclusion Evaluation tools for each three target groups should be designed to accommodate all three levels of evaluation and be guided by tobacco control conventions and nationally tailored indicators. As our results demonstrate, we extracted 82 “applied indicators” that comprised all levels of evaluation in the three target groups. Conflict of Interest: None declared.