Economic Evaluation of Five Tobacco Control Policies Across Seven European Countries

• Type: Article in International Scientific Journal
• Date: 2020

Authors

Leão, T (Author) FMUP; Perelman, J (Author) Other; Clancy, L (Author) Other; Mlinari¿, M (Author) Other; Kinnunen, JM (Author) Other; Nuyts, PAW (Author) Other; Mélard, N (Author) Other; Rimpelä, A (Author) Other; Lorant, V (Author) Other; Kunst, AE (Author) Other

Journal

Title: NICOTINE & TOBACCO RESEARCH

ISSN: 1462-2203

Indexing

ISI Web of Knowledge - 0 Citations

Scopus - 4 Citations

Other information

Authenticus ID: P-00S-AKM

DOI: 10.1093/ntr/ntz124

Abstract (EN): INTRODUCTION: Economic evaluations of tobacco control policies targeting adolescents are scarce. Few take into account real-world, large-scale implementation costs; few compare cost-effectiveness of different policies across different countries. We assessed the cost-effectiveness of five tobacco control policies (nonschool bans, including bans on sales to minors, bans on smoking in public places, bans on advertising at points-of-sale, school smoke-free bans, and school education programs), implemented in 2016 in Finland, Ireland, the Netherlands, Belgium, Germany, Italy, and Portugal. METHODS: Cost-effectiveness estimates were calculated per country and per policy, from the State perspective. Costs were collected by combining quantitative questionnaires with semi-structured interviews on how policies were implemented in each setting, in real practice. Short-term effectiveness was based on the literature, and long-term effectiveness was modeled using the DYNAMO-HIA tool. Discount rates of 3.5% were used for costs and effectiveness. Sensitivity analyses considered 1%-50% short-term effectiveness estimates, highest cost estimates, and undiscounted effectiveness. FINDINGS: Nonschool bans cost up to ¤253.23 per healthy life year, school smoking bans up to ¤91.87 per healthy life year, and school education programs up to ¤481.35 per healthy life year. Cost-effectiveness depended on the costs of implementation, short-term effectiveness, initial smoking rates, dimension of the target population, and weight of smoking in overall mortality and morbidity. CONCLUSIONS: All five policies were highly cost-effective in all countries according to the World Health Organization thresholds for public health interventions. Cost-effectiveness was preserved even when using the highest costs and most conservative effectiveness estimates. IMPLICATIONS: Economic evaluations using real-world data on tobacco control policies implemented at a large scale are scarce, especially considering nonschool bans targeting adolescents. We assessed the cost-effectiveness of five tobacco control policies implemented in 2016 in Finland, Ireland, the Netherlands, Belgium, Germany, Italy, and Portugal. This study shows that all five policies were highly cost-effective considering the World Health Organization threshold, even when considering the highest costs and most conservative effectiveness estimates. © The Author(s) 2019. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco.

Language: English

Type (Professor's evaluation): Dissemination