Finland is the first country to stipulate in law that its aim is to end the use of tobacco products containing compounds that are toxic to humans and that create addiction. This paper describes the development of a simulation model examining the potential effect of tobacco control policies in Finland on smoking prevalence and associated future premature mortality.
The model is developed using the SimSmoke simulation model of tobacco control policy, previously developed for other nations. The model uses population, smoking rates, and tobacco control policy data for Finland. It assesses, individually, and in combination, the effect of seven types of policies: taxes, smoke-free air laws, mass media campaigns, advertising bans, warning labels, cessation treatment, and youth access policies.
With a comprehensive set of policies, smoking prevalence can be decreased by as much as 15% in the first few years, increasing to 29% by 20 years and 34% by 30 years. By 2040, 1300 deaths can be averted in that year alone with the stronger set of policies. Without effective tobacco control policies, 23,000 additional lives will be lost due to smoking over all years through 2040.
The model shows that significant inroads to reducing smoking prevalence and premature mortality can be achieved through tax increases, a high-intensity media campaign complete with programmes to encourage cessation, a comprehensive cessation treatment programme, stronger health warnings, and enforcement of youth access laws. Other policies will be needed to further reduce tobacco use.
"Both of these nations had implemented a strong set of policies explaining the relatively large reductions in smoking prevalence. Finland (Levy et al. 2012a), Italy, Netherlands (Nagelhout et al. 2012) and Spain, which had implemented or already had a moderate set of policies, showed reductions in smoking rates comparable to those predicted by SimSmoke over a nine year period or longer. Sweden SimSmoke begins with data from 2004 and predicts reasonably well. "
[Show abstract][Hide abstract] ABSTRACT: Introduction:
This article compares the predicted impact of tobacco tax increases alone and as part of a comprehensive tobacco control strategy on smoking prevalence and smoking-attributable deaths (SADs) across 15 European countries.
Country-specific population, smoking prevalence and policy data with modified parameter values have been applied to the previously validated SimSmoke model for 10 high-income and 5 middle-income European nations. The impact of past and potential future policies is modelled.
Models generally validated well across the 15 countries, and showed the impact of past policies. Without stronger future policies, 44 million lives would be lost due to smoking across the 15 study countries between 2011 and 2040, but effective policies could avert 7.7 million of those premature deaths.
Results suggest that past policies have been effective in reducing smoking rates, but there is also a strong potential for future policies consistent with the Framework Convention on Tobacco Control. When specific taxes are increased to 70% of retail price, strong smoke-free air laws, youth access laws and marketing restrictions are enforced, stronger health warnings are implemented, and cessation treatment and media campaigns are supported, smoking prevalence and SADs will fall substantially in European countries.
Health Policy and Planning 11/2013; 29(8). DOI:10.1093/heapol/czt085 · 3.47 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Brazil has reduced its smoking rate by about 50% in the last 20 y. During that time period, strong tobacco control policies were implemented. This paper estimates the effect of these stricter policies on smoking prevalence and associated premature mortality, and the effect that additional policies may have.
The model was developed using the SimSmoke tobacco control policy model. Using policy, population, and smoking data for Brazil, the model assesses the effect on premature deaths of cigarette taxes, smoke-free air laws, mass media campaigns, marketing restrictions, packaging requirements, cessation treatment programs, and youth access restrictions. We estimate the effect of past policies relative to a counterfactual of policies kept to 1989 levels, and the effect of stricter future policies. Male and female smoking prevalence in Brazil have fallen by about half since 1989, which represents a 46% (lower and upper bounds: 28%-66%) relative reduction compared to the 2010 prevalence under the counterfactual scenario of policies held to 1989 levels. Almost half of that 46% reduction is explained by price increases, 14% by smoke-free air laws, 14% by marketing restrictions, 8% by health warnings, 6% by mass media campaigns, and 10% by cessation treatment programs. As a result of the past policies, a total of almost 420,000 (260,000-715,000) deaths had been averted by 2010, increasing to almost 7 million (4.5 million-10.3 million) deaths projected by 2050. Comparing future implementation of a set of stricter policies to a scenario with 2010 policies held constant, smoking prevalence by 2050 could be reduced by another 39% (29%-54%), and 1.3 million (0.9 million-2.0 million) out of 9 million future premature deaths could be averted.
Brazil provides one of the outstanding public health success stories in reducing deaths due to smoking, and serves as a model for other low and middle income nations. However, a set of stricter policies could further reduce smoking and save many additional lives. Please see later in the article for the Editors' Summary.
PLoS Medicine 11/2012; 9(11):e1001336. DOI:10.1371/journal.pmed.1001336 · 14.43 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: To evaluate the global impact of adopting highest-level MPOWER tobacco control policies in different countries and territories from 2007 to 2010.
Policy effect sizes based on previously-validated SimSmoke models were applied to determine the reduction in the number of smokers as a result of policy adoption during this period. Based on previous research suggesting that half of all smokers die from smoking, we also derived the estimated smoking-attributable deaths (SADs) averted due to MPOWER policy implementation. The results from use of this simple yet powerful method are consistent with those predicted by using previously validated SimSmoke models.
In total, 41 countries adopted at least one highest-level MPOWER policy between 2007 and 2010. As a result of all policies adopted during this period, the number of smokers is estimated to have dropped by 14.8 million, with a total of 7.4 million SADs averted. The largest number of SADs was averted as a result of increased cigarette taxes (3.5 million), smoke-free air laws (2.5 million), health warnings (700 000), cessation treatments (380 000), and bans on tobacco marketing (306 000).
From 2007 to 2010, 41 countries and territories took action that will collectively prevent nearly 7.5 million smoking-related deaths globally. These findings demonstrate the magnitude of the actions already taken by countries and underscore the potential for millions of additional lives to be saved with continued adoption of MPOWER policies.
Bulletin of the World Health Organisation 07/2013; 91(7):509-18. DOI:10.2471/BLT.12.113878 · 5.09 Impact Factor
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