TY - JOUR
T1 - Economic evaluation of five tobacco control policies across seven European countries
AU - Leão, Teresa
AU - Perelman, Julian
AU - Clancy, Luke
AU - Mlinarić, Martin
AU - Kinnunen, Jaana M
AU - Nuyts, Paulien A W
AU - Mélard, Nora
AU - Rimpela, Arja
AU - Lorant, Vincent
AU - Kunst, Anton E
N1 - © The Author(s) 2019. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: [email protected].
PY - 2020
Y1 - 2020
N2 - 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 (non-school 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 programmes), 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 modelled using the DYNAMO-HIA tool. Discount rates of 3.5% were used for costs and effectiveness. Sensitivity analyses considered 1% to 50% short-term effectiveness estimates, highest cost estimates, and undiscounted effectiveness.FINDINGS: Non-school bans cost up to €253.23 per healthy life year, school smoking bans up to €91.87 per healthy life year, and school education programmes 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 non-school 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 WHO threshold, even when considering the highest costs and most conservative effectiveness estimates.
AB - 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 (non-school 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 programmes), 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 modelled using the DYNAMO-HIA tool. Discount rates of 3.5% were used for costs and effectiveness. Sensitivity analyses considered 1% to 50% short-term effectiveness estimates, highest cost estimates, and undiscounted effectiveness.FINDINGS: Non-school bans cost up to €253.23 per healthy life year, school smoking bans up to €91.87 per healthy life year, and school education programmes 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 non-school 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 WHO threshold, even when considering the highest costs and most conservative effectiveness estimates.
U2 - 10.1093/ntr/ntz124
DO - 10.1093/ntr/ntz124
M3 - Article
C2 - 31350556
SN - 1462-2203
VL - 22
SP - 1202
EP - 1209
JO - Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco
JF - Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco
IS - 7
ER -