Titre : | Economic evaluation of five tobacco control policies across seven European countries (2020) |
Auteurs : | T. LEAO ; J. PERELMAN ; L. CLANCY ; M. MLINARIC ; J. M. KINNUNEN ; P. A. W. NUYTS ; N. MELARD ; A. RIMPELA ; V. LORANT ; A. E. KUNST |
Type de document : | Article : Périodique |
Dans : | Nicotine and Tobacco Research (Vol.22, n°7, July 2020) |
Article en page(s) : | 1202-1209 |
Langues: | Anglais |
Discipline : | SAN (Santé publique / Public health) |
Mots-clés : |
Thésaurus géographique EUROPE ; FINLANDE ; IRLANDE ; PAYS-BAS ; BELGIQUE ; ALLEMAGNE ; ITALIE ; PORTUGALThésaurus mots-clés TABAC ; POLITIQUE ; EVALUATION ; ECONOMIE ; COUT ; EFFICACITE ; INTERDICTION DE FUMER ; PUBLICITE ; EDUCATION POUR LA SANTE |
Résumé : |
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. |
Domaine : | Tabac / Tobacco / e-cigarette |
Refs biblio. : | 49 |
Affiliation : | Escola Nacional de Saude Publica, Universidade NOVA de Lisboa, Lisboa, Portugal |
Lien : | https://doi.org/10.1093/ntr/ntz124 |
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