Impact of five tobacco endgame strategies on future smoking prevalence, population health and health system costs: two modelling studies to inform the tobacco endgame

Abstract

Implementing endgame strategies is needed to achieve tobacco endgame targets and reduce inequalities in smoking. Given such strategies are new, modelling studies provide provisional information on what approaches may be best.

Mass media promotion of a smartphone smoking cessation app: modelled health and cost-saving impacts

“…In modelling health gain and net health system costs we used a well-established Markov macro-simulation model utilizing a multi-state life-table approach: the "BODE 3 Tobacco Model" including probabilistic uncertainty about multiple input parameters [12,[19][20][21][22][23]. This model includes 16 tobacco-related diseases using national data by sex, age and ethnicity for the whole New Zealand population in 2011.…”

“…This is a high-income country with a national Smokefree Goal for 2025 [13]. It is also a country where tobacco control has a very large potential for health gain and cost-savings (eg, in one modelling study: 282,000 QALYs gained and NZ$5.4 billion in cost savings for a sinking lid intervention on tobacco supplies [14]). Furthermore differences in tobacco use [15] is a major contributor to health inequalities, especially between Māori (Indigenous population) and non-Māori New Zealanders [16].…”

Estimating the health benefits and cost-savings of a cap on the size of single serve sugar-sweetened beverages

“…We used a multi-state life-table model to estimate the difference in quality-adjusted life-years (QALYs) and health system costs between the current New Zealand diet and the same diet where a 250 ml SSB cap has been implemented to reduce the serving size of all single serve SSB (as a strategy to reduce total and free sugar intake and total energy intake). The MSLT model was built from an established tobacco control MSLT model (using many of the same diseases), from which we have published work previously (41,42), which was built from a combination of two ACE models, one on the prevention of alcohol-related disease and injury (43) The intervention was modeled as if it were put in place in the base year (2011) and kept in place indefinitely. The 'base case' model used 3% discounting which reduced the reported outputs by 3% each year and took a health system perspective (i.e.…”

Restricting tobacco sales to only pharmacies as an endgame strategy: are pharmacies likely to opt in?

“…Given the New Zealand Government's goal of achieving minimal levels of smoking prevalence and tobacco availability by 2025, 3 and the likely need for bold measures to achieve this goal, 4 this research started to explore pharmacist attitudes in the New Zealand setting.…”

“…The acceptability of such an endgame strategy among pharmacists is likely to be an important determinant of political acceptability and so it is potentially useful to survey their attitudes. Given the New Zealand Government's goal of achieving minimal levels of smoking prevalence and tobacco availability by 2025, 3 and the likely need for bold measures to achieve this goal, 4 this research started to explore pharmacist attitudes in the New Zealand setting.…”