Modelling the implications of reducing smoking prevalence: the public health and economic benefits of achieving a "tobacco-free' UK

作者：Hunt Daniel; Knuchel Takano Andre; Jaccard Abbygail; Bhimjiyani Arti; Retat Lise; Selvarajah Chit; Brown Katrina; Webber Laura L^*; Brown Martin

来源：Tobacco Control, 2018, 27(2): 129-135.

DOI：10.1136/tobaccocontrol-2016-053507

• End game
• tobacco-free
• tobacco microsimulation
• disease burden
• economic burden

Introduction Smoking is still the most preventable cause of cancer, and a leading cause of premature mortality and health inequalities in the UK. This study modelled the health and economic impacts of achieving a tobacco-free' ambition (TFA) where, by 2035, less than 5% of the population smoke tobacco across all socioeconomic groups.
Methods A non-linear multivariate regression model was fitted to cross-sectional smoking data to create projections to 2035. These projections were used to predict the future incidence and costs of 17 smoking-related diseases using a microsimulation approach. The health and economic impacts of achieving a TFA were evaluated against a predicted baseline scenario, where current smoking trends continue.
Results If trends continue, the prevalence of smoking in the UK was projected to be 10% by 2035well above a TFA. If this ambition were achieved by 2035, it could mean 97300 +/- 5 300 new cases of smoking-related diseases are avoided by 2035 (tobacco-related cancers: 35900+/- 4 100; chronic obstructive pulmonary disease: 29000 +/- 2 700; stroke: 24900 +/- 2 700; coronary heart disease: 7600 +/- 2 700), including around 12350 diseases avoided in 2035 alone. The consequence of this health improvement is predicted to avoid 67 +/- 8 million in direct National Health Service and social care costs, and 548 pound million in non-health costs, in 2035 alone.
Conclusion These findings strengthen the case to set bold targets on long-term declines in smoking prevalence to achieve a tobacco endgame'. Results demonstrate the health and economic benefits that meeting a TFA can achieve over just 20 years. Effective ambitions and policy interventions are needed to reduce the disease and economic burden of smoking.

• 出版日期2018-3