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Economic Evaluation of Five Tobacco Control Policies Across Seven European Countries
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 con...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7291799/ https://www.ncbi.nlm.nih.gov/pubmed/31350556 http://dx.doi.org/10.1093/ntr/ntz124 |
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author | Leão, Teresa Perelman, Julian Clancy, Luke Mlinarić, Martin Kinnunen, Jaana M Nuyts, Paulien A W Mélard, Nora Rimpelä, Arja Lorant, Vincent Kunst, Anton E |
author_facet | Leão, Teresa Perelman, Julian Clancy, Luke Mlinarić, Martin Kinnunen, Jaana M Nuyts, Paulien A W Mélard, Nora Rimpelä, Arja Lorant, Vincent Kunst, Anton E |
author_sort | Leão, Teresa |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-7291799 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-72917992020-06-16 Economic Evaluation of Five Tobacco Control Policies Across Seven European Countries Leão, Teresa Perelman, Julian Clancy, Luke Mlinarić, Martin Kinnunen, Jaana M Nuyts, Paulien A W Mélard, Nora Rimpelä, Arja Lorant, Vincent Kunst, Anton E Nicotine Tob Res Original Investigations 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. Oxford University Press 2019-07-27 /pmc/articles/PMC7291799/ /pubmed/31350556 http://dx.doi.org/10.1093/ntr/ntz124 Text en © The Author(s) 2019. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Original Investigations Leão, Teresa Perelman, Julian Clancy, Luke Mlinarić, Martin Kinnunen, Jaana M Nuyts, Paulien A W Mélard, Nora Rimpelä, Arja Lorant, Vincent Kunst, Anton E Economic Evaluation of Five Tobacco Control Policies Across Seven European Countries |
title | Economic Evaluation of Five Tobacco Control Policies Across Seven European Countries |
title_full | Economic Evaluation of Five Tobacco Control Policies Across Seven European Countries |
title_fullStr | Economic Evaluation of Five Tobacco Control Policies Across Seven European Countries |
title_full_unstemmed | Economic Evaluation of Five Tobacco Control Policies Across Seven European Countries |
title_short | Economic Evaluation of Five Tobacco Control Policies Across Seven European Countries |
title_sort | economic evaluation of five tobacco control policies across seven european countries |
topic | Original Investigations |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7291799/ https://www.ncbi.nlm.nih.gov/pubmed/31350556 http://dx.doi.org/10.1093/ntr/ntz124 |
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