Reprinted with permission from Taylor and Francis Group. Article published in Nicotine and Tobacco Research (2002), 4, 311-319..


Global and Regional Estimates of the Effectiveness and Cost-Effectiveness of Price Increases and other Tobacco Control Policies.

by
Ranson, Kent
Prabhat, Jha
Chaloupka, Frank J.
Nguyen Son N.

ABSTRACT

The objective of this study was to provide conservative estimates of the global and regional effectiveness and cost-effectiveness of tobacco control policies. Using a static model of the cohort of smokers alive in 1995, we estimated the number of smoking-attributable deaths that could be averted by: (1) price increases, (2) nicotine replacement therapy (NRT), and (3) a package of non-price interventions other than NRT. We calculated the cost-effectiveness of these policy interventions by weighing the approximate public-sector costs against the years of healthy life saved, measured in disability-adjusted life years, or DALYs. Even with deliberately conservative assumptions, tax increases that would raise the price of cigarettes by 10% worldwide would prevent between 5 and 16 million tobacco-related deaths, and could cost US$3-70 per DALY saved in low-income and middle-income regions. NRT and a package of non-price interventions other than NRT are also cost-effective in low-income and middle-income regions, at US$280-870 per DALY and US$36-710 per DALY, respectively. In high-income countries, price increases were found to have a cost-effectiveness of US$83-2771 per DALY, NRT US $750-7206 per DALY and other non-price interventions US$696-13,924 per DALY. Tobacco control policies, particularly tax increases on cigarettes, are cost-effective relative to other health interventions. Our estimates are subject to considerable variation in actual settings; thus, local cost-effectiveness studies are required to guide local policy.



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