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Blakely T, Howe S. Burden of proof to attribute risk factor contributions to the global burden of disease. Lancet 2024; 403:1960-1961. [PMID: 38762311 DOI: 10.1016/s0140-6736(24)00969-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Accepted: 05/07/2024] [Indexed: 05/20/2024]
Affiliation(s)
- Tony Blakely
- Population Interventions Unit, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia.
| | - Samantha Howe
- Population Interventions Unit, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
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2
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Ruokolainen O, Ollila H, Laatikainen T, Pätsi SM, Carreras G, Gorini G, Carnicer-Pont D, Cselkó Z, Guignard R, Karekla M, Kilibarda B, Koprivnikar H, Lambrou A, Nguyen-Thanh V, Papachristou E, Schoretsaniti S, Vasic M. Tobacco endgame measures and their adaptation in selected European countries: A narrative review synthesis. Tob Prev Cessat 2024; 10:TPC-10-18. [PMID: 38638446 PMCID: PMC11025294 DOI: 10.18332/tpc/186402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 03/22/2024] [Accepted: 03/22/2024] [Indexed: 04/20/2024]
Abstract
Due to the continued detrimental effects of tobacco use, a growing number of countries are embracing the idea of tobacco endgame, meaning ending the tobacco epidemic instead of controlling it. This narrative review aims to synthesize and update the evidence from earlier scientific reviews on effective tobacco endgame measures, as well as to assess their integration to current national strategies among European countries with official tobacco endgame goals. The synthesis of the prior scientific literature found most evidence on product-focused and some evidence for supply-focused policies. Little evidence was detected for user- and institutional-focused measures. An update for the tobacco-free generation measure showed uncertainty in reducing smoking prevalence, especially for adolescents' reactions to age-restrictive laws. All the countries that established a tobacco endgame strategy have included product standards in their measures, predominantly based on European Union regulations on conventional tobacco products, yet standards above this level and considering other products were also common. Cessation measures were given strong emphasis in strategies, yet none of the countries linked these to specific endgame measures. Despite commonly mentioning vulnerable groups, such as youth and pregnant women, adoption of measures to reduce tobacco use among these groups was scarce. Lastly, the decline in tobacco use seems to be modest, implying challenges in meeting the endgame goals. To meet these goals, European countries should reinforce the implementation of known effective tobacco control measures such as tax increases. Furthermore, new innovative strategies and measures to meet the objective of an endgame should be explored.
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Affiliation(s)
- Otto Ruokolainen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Hanna Ollila
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Tiina Laatikainen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Salla-Maaria Pätsi
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Giulia Carreras
- Institute for Cancer Research, Prevention and Clinical Network, Florence, Italy
| | - Giuseppe Gorini
- Institute for Cancer Research, Prevention and Clinical Network, Florence, Italy
| | - Dolors Carnicer-Pont
- Grupo de Investigación en Control del Tabaco, Institut d'Investigació Biomèdica de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, Madrid, Spain
- Programa de Prevenció i Control del Càncer, Institut Català d'Oncologia, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Zsuzsa Cselkó
- National Korányi Institute of Pulmonology, Budapest, Hungary
| | - Romain Guignard
- Prevention and Health Promotion Department, Santé publique France, Saint-Maurice, France
| | | | - Biljana Kilibarda
- Institute of Public Health of Serbia ‘Dr Milan Jovanovic Batut’, Belgrade, Serbia
| | | | - Angeliki Lambrou
- Directorate of Epidemiology and Prevention of Non-Communicable Diseases and Injuries, National Public Health Organization, Athens, Greece
| | - Viêt Nguyen-Thanh
- Prevention and Health Promotion Department, Santé publique France, Saint-Maurice, France
| | - Efstathios Papachristou
- Directorate of Epidemiology and Prevention of Non-Communicable Diseases and Injuries, National Public Health Organization, Athens, Greece
| | - Sotiria Schoretsaniti
- Directorate of Epidemiology and Prevention of Non-Communicable Diseases and Injuries, National Public Health Organization, Athens, Greece
| | - Milena Vasic
- Institute of Public Health of Serbia ‘Dr Milan Jovanovic Batut’, Belgrade, Serbia
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Buss VH, Shahab L, Bauld L, Kock L, Cheeseman H, Brown J. 'Stopping the start': support for proposed tobacco control policies - a population-based survey in Great Britain 2021-2023. Tob Control 2024:tc-2023-058571. [PMID: 38609176 DOI: 10.1136/tc-2023-058571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 04/04/2024] [Indexed: 04/14/2024]
Abstract
OBJECTIVES This study assessed public support for four proposed tobacco control policies in Great Britain: (1) Raising the sales age of tobacco by 1 year every year (Smokefree Generation); (2) Raising the sales age of tobacco from 18 years to 21 years; (3) Providing prescription e-cigarettes as smoking cessation aids to adults who smoke; (4) Restricting e-cigarette advertising to prevent youth uptake. DESIGN Repeat cross-sectional population-based survey weighted to match the population of Great Britain. SETTING The survey was conducted in England, Scotland and Wales in September 2021, October 2022 and October 2023. PARTICIPANTS 6541 adults living in Great Britain. MAIN OUTCOME MEASURES Support for each policy and year and prevalence ratios (PRs) comparing support between years and subgroups. RESULTS The most popular policy each year was restricting e-cigarette advertising (74%/79%/85%), followed by raising the sales age to 21 years (50%/58%/64%), providing prescription e-cigarettes (45%/44%/47%) and Smokefree Generation (34%/44%/49%). The largest increases were for policies about the age of sale (Smokefree Generation: 2021/2022 PR=1.28, 95% CI 1.18 to 1.40, 2022/2023 PR=1.12, 95% CI 1.04 to 1.20; raising the age to 21 years: 2021/2022 PR=1.16, 95% CI 1.09 to 1.23, 2022/2023 PR=1.11, 95% CI 1.05 to 1.17). Only 30% opposed Smokefree Generation in 2023 down from 41% in 2021. CONCLUSIONS Support for each policy increased each year, except for providing prescription e-cigarettes. Restricting e-cigarette advertising was the most popular policy, while support for age of sale policies, in particular for a Smokefree Generation, grew most. TRIAL REGISTRATION The study protocol was published on the Open Science Framework (https://osf.io/46z2c/) prior to starting the analysis.
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Affiliation(s)
- Vera Helen Buss
- Behavioural Science and Health, University College London, London, UK
- SPECTRUM Consortium, Edinburgh, UK
| | - Lion Shahab
- Behavioural Science and Health, University College London, London, UK
- SPECTRUM Consortium, Edinburgh, UK
| | - Linda Bauld
- SPECTRUM Consortium, Edinburgh, UK
- Usher Institute and UK Centre for Tobacco and Alcohol Studies, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK
| | - Loren Kock
- Behavioural Science and Health, University College London, London, UK
- Vermont Center on Behavior and Health, University of Vermont, Burlington, Vermont, USA
| | - Hazel Cheeseman
- SPECTRUM Consortium, Edinburgh, UK
- Action on Smoking and Health, London, UK
| | - Jamie Brown
- Behavioural Science and Health, University College London, London, UK
- SPECTRUM Consortium, Edinburgh, UK
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Hanewinkel R, Hansen J. [Use of tobacco cigarettes, e-cigarettes, and shishas among children and adolescents: Results of the 'Präventionsradar' from 2016 to 2023]. Laryngorhinootologie 2024. [PMID: 38408484 DOI: 10.1055/a-2249-3796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2024]
Abstract
AIM To measure trends in the use of various smoking products among children and adolescents from 2016 to 2023. METHOD The data is based on seven waves of the "Präventionsradar", a school-based epidemiological study in grades 5 to 10. The primary endpoints of the study were the lifetime and monthly prevalence of the use of tobacco cigarettes, e-cigarettes, shisha and the use of at least two of these smoking products (combined use). Prevalence estimates are based on logistic regression models. RESULTS The analysis was based on 94,127 questionnaires. The sex ratio was balanced (49% female), mean age was 13 years (SD=1.8). In 2022/2023, the lifetime prevalence of smoking tobacco cigarettes was 18.8% (95% CI 18.1-19.5), of e-cigarettes 23.5% (95% CI 22.8-24.3), of shisha 14.0% (95% CI 13.4-14.7) and combined use 19.0% (95% CI 18.3-19.7). The monthly prevalence of smoking tobacco cigarettes was 5.9% (95% CI 5.5-6.4), of e-cigarettes 7.0% (95% CI 6.5-7.4), of shisha 3.2% (95% CI 2.8-3.5) and combined use 4.8% (95% CI 4.4-5.2). The following trends in lifetime prevalence have emerged since 2016: tobacco cigarettes (-3.0 percentage points), e-cigarettes (+1.8 percentage points), shisha (-9.2 percentage points), combined use (-2.7 percentage points). In the years of the COVID-19 pandemic, youth smoking decreased and rose again post-COVID with the exception of shisha. DISCUSSION The use of smoking products in adolescence occurs frequently. Over the observational period, a trend reversal towards e-cigarettes as the most popular product among children and young people is most likely. In addition, the combined use of several smoking products has become a common pattern of consumption. Consistent preventive measures are required in order to achieve the goal of a smoke-free society in 2040.
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Affiliation(s)
- Reiner Hanewinkel
- IFT-Nord gGmbH, Institut für Therapie- und Gesundheitsforschung, Kiel, Deutschland
| | - Julia Hansen
- IFT-Nord gGmbH, Institut für Therapie- und Gesundheitsforschung, Kiel, Deutschland
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Joó T, Foley K, Brys Z, Rogers T, Szócska M, Bodrogi J, Gaál P, Pénzes M. Impact of regulatory tightening of the Hungarian tobacco retail market on availability, access and cigarette smoking prevalence of adolescents. Tob Control 2024:tc-2023-058232. [PMID: 38242687 DOI: 10.1136/tc-2023-058232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 01/10/2024] [Indexed: 01/21/2024]
Abstract
INTRODUCTION Policies that reduce tobacco retail density to decrease tobacco use among the youth are critical for the tobacco endgame. This paper reviews a Hungarian tobacco regulatory measure, which, since 2013, has confined the sale of tobacco products exclusively to so-called National Tobacco Shops, summarises the changes in the national tobacco retail marketplace and reports on analyses of the impact of this intervention on illegal sales to minors and adolescent smoking behaviour. METHODS We reviewed the available national statistical data on the structure and dynamics of the tobacco retail market. Changes in lifetime and current (past 30 days) use of cigarettes among Hungarian adolescents aged 13-17 years were assessed using data from international youth surveys on health behaviours collected in 2010-2020. RESULTS Since the start of policy implementation, the density of tobacco shops in Hungary decreased by 85%, from 4.1 to 0.6 per 1000 persons. The prevalence of lifetime and current cigarette smoking among adolescents declined by 13-24 percentage points (pp) and by 4.8-15 pp, respectively. The rate of illegal sales of tobacco products to minors decreased by 27.6 pp, although the prevalence of compensatory access strategies, especially asking others to buy cigarettes for minors, increased. CONCLUSIONS After a significant decrease in the nationwide availability of licensed tobacco retailers, Hungary experienced short-term reductions in youth smoking prevalence. However, the sporadic implementation of complementary, evidence-based tobacco control strategies might limit further declines in youth smoking initiation and tobacco product use.
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Affiliation(s)
- Tamás Joó
- Data-Driven Health Division of the National Laboratory for Health Security, Health Services Management Training Centre, Semmelweis University, Budapest, Hungary
- Hungarian Healthcare Management Association, Budapest, Hungary
| | - Kristie Foley
- Implementation Science, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Zoltán Brys
- Doctoral School of Mental Health Sciences, Semmelweis University, Budapest, Hungary
- Centre for Social Sciences, Institute for Sociology, Budapest, Hungary
| | - Todd Rogers
- Public Health Division, RTI International, Research Triangle Park, North Carolina, USA
| | - Miklós Szócska
- Health Services Management Training Centre, Semmelweis University, Budapest, Hungary
| | - József Bodrogi
- University Pharmacy Department of Pharmacy Administration, Semmelweis University, Budapest, Hungary
| | - Péter Gaál
- Hungarian Healthcare Management Association, Budapest, Hungary
- Health Services Management Training Centre, Semmelweis University, Budapest, Hungary
| | - Melinda Pénzes
- Data-Driven Health Division of the National Laboratory for Health Security, Health Services Management Training Centre, Semmelweis University, Budapest, Hungary
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Hanewinkel R, Hansen J. Regional socioeconomic deprivation in Germany and nicotine use among children and adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2024; 34:1023-1033. [PMID: 36966513 DOI: 10.1080/09603123.2023.2195155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 03/21/2023] [Indexed: 06/18/2023]
Abstract
To assess the association of regional socioeconomic deprivation and nicotine use, survey data from 17,877 pupils aged 9-17 years were analysed. Lifetime use of combustible, e-cigarettes, and both products were the outcome variables. The German Index of Socioeconomic Deprivation was the exposure variable. Logistic regression models controlling for age, gender, school type, and sensation seeking were used to examine associations between regional socioeconomic deprivation and nicotine use. Ever use of combustible cigarettes was 17.8%, of e-cigarettes 19.6%, and of both products 13.4%. Compared to the most affluent area, the adjusted odds ratio of combustible cigarette use in the most deprived area was 2.24 (95% CI: 1.67-3.00), of e-cigarette use 1.56 (95% CI: 1.20-2.03), and of poly use 1.91 (95% CI: 1.36-2.69). Nicotine use among young people across ages and especially in socioeconomic-deprived areas was widespread. Nicotine control measures are urgently needed to reduce smoking and vaping in German adolescents.
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Affiliation(s)
| | - Julia Hansen
- Institute for Therapy and Health Research, Kiel, Germany
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Gendall P, Popova L, Thrasher J, Hoek J. Nicotine beliefs and perceptions of low nicotine labels and mitigating statements among people who do and do not smoke: a cross-sectional study from Aotearoa New Zealand. Tob Control 2024:tc-2023-058353. [PMID: 38195244 DOI: 10.1136/tc-2023-058353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 12/13/2023] [Indexed: 01/11/2024]
Abstract
BACKGROUND Aotearoa New Zealand proposed a new maximum nicotine content of 0.8 mg/g for smoked tobacco products, although the new government plans to repeal this legislation. Requiring 'Very low nicotine' (VLN) messages on cigarettes meeting this standard may reinforce misperceptions that they are less harmful than cigarettes currently sold. METHODS To explore knowledge of nicotine and very low nicotine cigarettes (VLNCs), and perceptions of cigarette packs featuring different low nicotine messages (eg, 'Very low nicotine') and mitigating statements (eg, 'No cigarettes are safe'), we surveyed 354 people who smoked, 142 who formerly smoked, and 214 people who had never smoked regularly. RESULTS Around half of all respondents believed VLNCs were less harmful than regular cigarettes and around two-thirds incorrectly thought nicotine causes most of the related health problems resulting from smoking. Nearly a third thought VLNCs would be less harmful than regular cigarettes; 34% believed they would be just as harmful. Mitigating statements did not affect perceptions of people who smoked, although people who formerly, or who had never smoked regularly, perceived mitigating statements referring to poisons and cancer as significantly more likely than the VLN message to discourage smoking. CONCLUSIONS Misunderstanding of VLNCs as less harmful than regular cigarettes is widespread; VLN messages may reinforce this misperception, which mitigating statements did not correct among people who smoke. As an alternative to VLN messages, policy makers could consider introducing VLNCs on a specified date and developing public information campaigns; these measures would avoid phase-in confusion and obviate the need for VLN messaging.
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Affiliation(s)
- Philip Gendall
- Public Health, University of Otago Wellington, Wellington, New Zealand
| | - Lucy Popova
- School of Public Health, Georgia State University, Atlanta, Georgia, USA
| | - James Thrasher
- Health Promotion, Education, and Behavior, School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Janet Hoek
- Public Health, University of Otago Wellington, Wellington, New Zealand
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8
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Boulton A. New Zealand's decision to scrap anti-smoking legislation will do immeasurable harm. BMJ 2023; 383:2956. [PMID: 38110240 DOI: 10.1136/bmj.p2956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2023]
Affiliation(s)
- Amohia Boulton
- Whakauae Research for Māori Health and Development, New Zealand
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9
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10
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Hanewinkel R, Hansen J. [Use of tobacco cigarettes, e-cigarettes, and shishas among children and adolescents: Results of the 'Präventionsradar' from 2016 to 2023]. Pneumologie 2023; 77:1001-1008. [PMID: 37758039 DOI: 10.1055/a-2146-7087] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/03/2023]
Abstract
AIM To measure trends in the use of various smoking products among children and adolescents from 2016 to 2023. METHOD The data is based on seven waves of the "Präventionsradar", a school-based epidemiological study in grades 5 to 10. The primary endpoints of the study were the lifetime and monthly prevalence of the use of tobacco cigarettes, e-cigarettes, shisha and the use of at least two of these smoking products (combined use). Prevalence estimates are based on logistic regression models. RESULTS The analysis was based on 94,127 questionnaires. The sex ratio was balanced (49% female), mean age was 13 years (SD=1.8). In 2022/2023, the lifetime prevalence of smoking tobacco cigarettes was 18.8% (95% CI 18.1-19.5), of e-cigarettes 23.5% (95% CI 22.8-24.3), of shisha 14.0% (95% CI 13.4-14.7) and combined use 19.0% (95% CI 18.3-19.7). The monthly prevalence of smoking tobacco cigarettes was 5.9% (95% CI 5.5-6.4), of e-cigarettes 7.0% (95% CI 6.5-7.4), of shisha 3.2% (95% CI 2.8-3.5) and combined use 4.8% (95% CI 4.4-5.2). The following trends in lifetime prevalence have emerged since 2016: tobacco cigarettes (-3.0 percentage points), e-cigarettes (+1.8 percentage points), shisha (-9.2 percentage points), combined use (-2.7 percentage points). In the years of the COVID-19 pandemic, youth smoking decreased and rose again post-COVID with the exception of shisha. DISCUSSION The use of smoking products in adolescence occurs frequently. Over the observational period, a trend reversal towards e-cigarettes as the most popular product among children and young people is most likely. In addition, the combined use of several smoking products has become a common pattern of consumption. Consistent preventive measures are required in order to achieve the goal of a smoke-free society in 2040.
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Affiliation(s)
- Reiner Hanewinkel
- IFT-Nord gGmbH, Institut für Therapie- und Gesundheitsforschung, Kiel, Deutschland
| | - Julia Hansen
- IFT-Nord gGmbH, Institut für Therapie- und Gesundheitsforschung, Kiel, Deutschland
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Ait Ouakrim D, Wilson T, Howe S, Clarke P, Gartner CE, Wilson N, Blakely T. Economic effects for citizens and the government of a country-level tobacco endgame strategy: a modelling study. Tob Control 2023:tc-2023-058131. [PMID: 38050170 DOI: 10.1136/tc-2023-058131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 10/31/2023] [Indexed: 12/06/2023]
Abstract
BACKGROUND Aotearoa-New Zealand (A/NZ) was the first country to pass a comprehensive commercial tobacco endgame strategy into law. Key components include the denicotinisation of smoked tobacco products and a major reduction in tobacco retail outlets. Understanding the potential long-term economic impacts of such measures is important for government planning. DESIGN A tobacco policy simulation model that evaluated the health impacts of the A/NZ Smokefree Action Plan was extended to evaluate the economic effects from both government and citizen perspectives. Estimates were presented in 2021 US$, discounted at 3% per annum. RESULTS The modelled endgame policy package generates considerable growth in income for the A/NZ population with a total cumulative gain of US$31 billion by 2050. From a government perspective, increased superannuation payments and reduced tobacco excise tax revenue result in a negative net financial position and a cumulative shortfall of US$11.5 billion by 2050. In a sensitivity analysis considering future labour force changes, the government's cumulative net position remained negative by 2050, but only by US$1.9 billion. CONCLUSIONS A policy such as the A/NZ Smokefree Action Plan is likely to produce substantial economic benefits for citizens, and modest impacts on government finances related to reduced tobacco tax and increases in aged pensions due to increased life expectancy. Such costs can be anticipated and planned for and might be largely offset by future increases in the size of the labour force and the proportion of people 65+ years old working in the formal economy.
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Affiliation(s)
- Driss Ait Ouakrim
- Population Interventions Unit, The University of Melbourne School of Population and Global Health, Melbourne, Victoria, Australia
| | - Tim Wilson
- Population Interventions Unit, The University of Melbourne School of Population and Global Health, Melbourne, Victoria, Australia
| | - Samantha Howe
- Population Interventions Unit, The University of Melbourne School of Population and Global Health, Melbourne, Victoria, Australia
| | - Philip Clarke
- Health Economics Research Centre, University of Oxford Nuffield Department of Medicine, Oxford, UK
| | - Coral E Gartner
- School of Public Health, University of Queensland, Herston, Queensland, Australia
| | - Nick Wilson
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Tony Blakely
- Population Interventions Unit, The University of Melbourne School of Population and Global Health, Melbourne, Victoria, Australia
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Kim H, Park S, Kang H, Kang N, Levy DT, Cho SI. Modeling the future of tobacco control: Using SimSmoke to explore the feasibility of the tobacco endgame in Korea. Tob Induc Dis 2023; 21:147. [PMID: 37954490 PMCID: PMC10632939 DOI: 10.18332/tid/174127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 10/11/2023] [Accepted: 10/14/2023] [Indexed: 11/14/2023] Open
Abstract
INTRODUCTION We used a simulation model to assess the feasibility of reaching the tobacco endgame target (reducing the smoking prevalence to below 5% by 2050) and explored potential implementation strategies. METHODS The impact of strengthened tobacco-control policies on smoking prevalence was analyzed using Korea SimSmoke, a discrete-time Markov process. We considered the effects of various scenarios from 2023 and predictions were conducted until 2050. To confirm the stability of the results, deterministic and probabilistic sensitivity analyses were carried out by increasing and decreasing parameter estimates. RESULTS The implementation of tobacco-control policies in accordance with the WHO MPOWER (Μonitor tobacco use and prevention policies; Protect people from tobacco smoke; Offer help to quit tobacco smoking; Warn of the dangers of tobacco; Enforce bans on tobacco advertising, promotion, and sponsorship; Raise taxes on tobacco) measures were insufficient to achieve the tobacco endgame objective of 5% by 2050. The overall predicted smoking prevalence in 2050 is 4.7% if all policies are fully implemented in accordance with the FCTC guidelines together with a complete ban on the sale of cigarettes to people born after 2003 and annual 10% increases in price. Sensitivity analyses using the varying policy effect assumptions demonstrated the robustness of the simulation results. CONCLUSIONS For a substantive reduction in smoking prevalence, it is essential to strongly implement the MPOWER strategy. Beyond this foundational step, the eradication of smoking requires a paradigm shift in the perception of conventional tobacco-control policies, including a tobacco-free generation strategy and radical increases in the price of tobacco products.
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Affiliation(s)
- Hana Kim
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Susan Park
- Institute of Health and Environment, Seoul National University, Seoul, Republic of Korea
| | - Heewon Kang
- Institute of Health and Environment, Seoul National University, Seoul, Republic of Korea
| | - Naeun Kang
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - David T. Levy
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, United States
| | - Sung-il Cho
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
- Institute of Health and Environment, Seoul National University, Seoul, Republic of Korea
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Marshall HM, Gartner CE, Fong KM. The tobacco endgame for the Asia Pacific. Respirology 2023; 28:309-312. [PMID: 36746604 PMCID: PMC10946527 DOI: 10.1111/resp.14465] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 01/24/2023] [Indexed: 02/08/2023]
Affiliation(s)
- Henry M Marshall
- The University of Queensland Thoracic Research Centre, Brisbane, Queensland, Australia
- The Department of Thoracic Medicine, The Prince Charles Hospital, Brisbane, Queensland, Australia
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
| | - Coral E Gartner
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
| | - Kwun M Fong
- The University of Queensland Thoracic Research Centre, Brisbane, Queensland, Australia
- The Department of Thoracic Medicine, The Prince Charles Hospital, Brisbane, Queensland, Australia
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14
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Cox DW, Rodriguez L, Grigg J. Statement on Tobacco 21 from the European Respiratory Society Tobacco Control Committee. Eur Respir J 2023; 61:61/3/2300134. [PMID: 36958744 DOI: 10.1183/13993003.00134-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 02/22/2023] [Indexed: 03/25/2023]
Affiliation(s)
- Des W Cox
- Respiratory Department, Children's Health Ireland, Dublin, Ireland
- University College Dublin, Dublin, Ireland
| | | | - Jonathan Grigg
- Centre for Child Health, Blizard Institute, Queen Mary University of London, London, UK
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