The health and economic burden of smoking in 12 Latin American countries and the potential effect of increasing tobacco taxes: an economic modelling study

Abstract

Background Worldwide, smoking tobacco causes 7 million deaths annually, and this toll is expected to increase, especially in low-income and middle-income countries. In Latin America, smoking is a leading risk factor for death and disability, contributes to poverty, and imposes an economic burden on health systems. Despite being one of the most effective measures to reduce smoking, tobacco taxation is underused and cigarettes are more affordable in Latin America than in other regions. Our aim was to estimate the tobacco-attributable burden on mortality, disease incidence, quality of life lost, and medical costs in 12 Latin American countries, and the expected health and economic effects of increasing tobacco taxes.Methods In this modelling study, we developed a Markov probabilistic microsimulation economic model of the natural history, medical costs, and quality-of-life losses associated with the most common tobacco-related diseases in 12 countries in Latin America. Data inputs were obtained through a literature review, vital statistics, and hospital databases from each country: Argentina,

Optimizing Tobacco Advertising Bans in Seven Latin American Countries: Microsimulation Modeling of Health and Financial Impact to Inform Evidence-Based Policy

“…In fact, a ban on advertising should be used in the context of other measures. In other studies, our group estimated the health and cost effects of applying tax increase, plain packaging, and smoke-free strategies in the region and found that the first strategy had the most significant effect [ 22 , 25 , 44 , 45 ]. However, as it occurs with the other measures, the effects of a comprehensive ban on tobacco advertising and sponsorship would result in important health benefits and savings for the health systems in the region.…”

“…The smoking burden model allows for the estimation of health and economic impact of tobacco, at present and after implementation of interventions to reduce smoking prevalence. This model has been validated and applied in studies carried out in 12 Latin American countries that estimated the burden of disease and the expected impact of tobacco tax increases and other strategies [ 25 , 27 , 28 , 29 , 30 , 31 , 32 , 33 ].…”

“…Health impact was calculated as the observed difference between baseline burden (status quo) and the complete ban strategy estimates, in terms of deaths, disease events, years lived, disability, and health costs. More information about the model can be found in the publications in which it was described, evaluated, or used [ 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 42 , 43 , 44 , 45 ], and in the technical reports with findings on the burden of disease (available from , access date 30 March 2021).…”

“…Despite an accelerating impact of MPOWER policies, the implementation of legislation related to tobacco advertising at a global level is still limited [ 20 , 21 , 22 ]; moreover, scarcity of quality information at a country-level, lobbying, and constituency building from the tobacco industry have delayed the implementation and enforcement of these measures in Latin America [ 23 , 24 ]. In the group of studied countries, Peru and Bolivia have the minimum level of implementation; Argentina and Mexico are in an intermediate level of implementation with a ban of advertising on national television, radio, print media, and some direct or indirect forms of advertising, and although Colombia, Brazil, and Chile have the maximum level of implementation with a comprehensive ban of all forms of advertising, there is still room for improvement in the compliance of measures [ 25 ].…”

The estimated benefits of increasing cigarette prices through taxation on the burden of disease and economic burden of smoking in Nigeria: A modeling study

“…The Institute for Clinical Effectiveness and Health Policy (IECS) coordinated a multi-country initiative to develop an economic model to estimate the tobacco-related disease and economic burden and evaluate the impact of different tobacco control interventions, including taxation, cigarette plain packaging, advertising, and smoke-free environments [ 7 ]. This model has been applied in several studies to estimate the burden of smoking and the potential impact of tobacco control interventions in different countries [ 8 – 13 ].…”