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A cost-effectiveness analysis of India's 2008 prohibition of smoking in public places in Gujarat.

Donaldson EA, Waters HR, Arora M, Varghese B, Dave P, Modi B - Int J Environ Res Public Health (2011)

Bottom Line: The aim of this study was to assess the cost-effectiveness of implementing India's Prohibition of Smoking in Public Places Rules in the state of Gujarat, compared to implementation of a complete smoking ban.Without including medical treatment costs averted, the cost-effectiveness ratio ranges from $2 to $112 per LY gained and $37 to $386 per acute myocardial infarction averted.Implementing a complete smoking ban would be a cost saving alternative to the current partial legislation in terms of reducing tobacco-attributable disease in Gujarat.

View Article: PubMed Central - PubMed

Affiliation: Institute for Global Tobacco Control, Johns Hopkins Bloomberg School of Public Health, 627 N Washington Street, 2nd Floor, Baltimore, MD 21205, USA. edonalds@jhsph.edu

ABSTRACT
Tobacco smoking and exposure to secondhand tobacco smoke are associated with disability and premature mortality in low and middle-income countries. The aim of this study was to assess the cost-effectiveness of implementing India's Prohibition of Smoking in Public Places Rules in the state of Gujarat, compared to implementation of a complete smoking ban. Using standard cost-effectiveness analysis methods, the cost of implementing the alternatives was evaluated against the years of life saved and cases of acute myocardial infarction averted by reductions in smoking prevalence and secondhand smoke exposure. After one year, it is estimated that a complete smoking ban in Gujarat would avert 17,000 additional heart attacks and gain 438,000 life years (LY). A complete ban is highly cost-effective when key variables including legislation effectiveness were varied in the sensitivity analyses. Without including medical treatment costs averted, the cost-effectiveness ratio ranges from $2 to $112 per LY gained and $37 to $386 per acute myocardial infarction averted. Implementing a complete smoking ban would be a cost saving alternative to the current partial legislation in terms of reducing tobacco-attributable disease in Gujarat.

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Related in: MedlinePlus

Cost per DALY averted for selected health interventions (adapted from [54]).
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f1-ijerph-08-01271: Cost per DALY averted for selected health interventions (adapted from [54]).

Mentions: A 2006 regional cost-effectiveness analysis of the cost per disability-adjusted life year (DALY) averted in South East Asia for clean indoor air enforcement was 340 USD (14,719 Rs) per DALY averted [53]. The current study found implementation of a complete smoking ban to be similarly cost-effective, even without consideration of medical treatment costs saved and the years lived with disability that are included in the calculation of DALYs and may be averted by a complete smoking ban. In addition, when comparing the cost of implementing a complete smoking ban in Gujarat with other health interventions in low- and middle-income countries, as illustrated in Figure 1, it remains comparatively cost-effective [54].


A cost-effectiveness analysis of India's 2008 prohibition of smoking in public places in Gujarat.

Donaldson EA, Waters HR, Arora M, Varghese B, Dave P, Modi B - Int J Environ Res Public Health (2011)

Cost per DALY averted for selected health interventions (adapted from [54]).
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC3108108&req=5

f1-ijerph-08-01271: Cost per DALY averted for selected health interventions (adapted from [54]).
Mentions: A 2006 regional cost-effectiveness analysis of the cost per disability-adjusted life year (DALY) averted in South East Asia for clean indoor air enforcement was 340 USD (14,719 Rs) per DALY averted [53]. The current study found implementation of a complete smoking ban to be similarly cost-effective, even without consideration of medical treatment costs saved and the years lived with disability that are included in the calculation of DALYs and may be averted by a complete smoking ban. In addition, when comparing the cost of implementing a complete smoking ban in Gujarat with other health interventions in low- and middle-income countries, as illustrated in Figure 1, it remains comparatively cost-effective [54].

Bottom Line: The aim of this study was to assess the cost-effectiveness of implementing India's Prohibition of Smoking in Public Places Rules in the state of Gujarat, compared to implementation of a complete smoking ban.Without including medical treatment costs averted, the cost-effectiveness ratio ranges from $2 to $112 per LY gained and $37 to $386 per acute myocardial infarction averted.Implementing a complete smoking ban would be a cost saving alternative to the current partial legislation in terms of reducing tobacco-attributable disease in Gujarat.

View Article: PubMed Central - PubMed

Affiliation: Institute for Global Tobacco Control, Johns Hopkins Bloomberg School of Public Health, 627 N Washington Street, 2nd Floor, Baltimore, MD 21205, USA. edonalds@jhsph.edu

ABSTRACT
Tobacco smoking and exposure to secondhand tobacco smoke are associated with disability and premature mortality in low and middle-income countries. The aim of this study was to assess the cost-effectiveness of implementing India's Prohibition of Smoking in Public Places Rules in the state of Gujarat, compared to implementation of a complete smoking ban. Using standard cost-effectiveness analysis methods, the cost of implementing the alternatives was evaluated against the years of life saved and cases of acute myocardial infarction averted by reductions in smoking prevalence and secondhand smoke exposure. After one year, it is estimated that a complete smoking ban in Gujarat would avert 17,000 additional heart attacks and gain 438,000 life years (LY). A complete ban is highly cost-effective when key variables including legislation effectiveness were varied in the sensitivity analyses. Without including medical treatment costs averted, the cost-effectiveness ratio ranges from $2 to $112 per LY gained and $37 to $386 per acute myocardial infarction averted. Implementing a complete smoking ban would be a cost saving alternative to the current partial legislation in terms of reducing tobacco-attributable disease in Gujarat.

Show MeSH
Related in: MedlinePlus