Abstract
AIMS: We compared predicted lifetime health care costs for current, never and ex-smokers in Germany under the current set of tobacco control polices. We compared these economic consequences of the current situation with an alternative in which Germany were to implement more comprehensive tobacco control policies consistent with the WHO Framework Convention for Tobacco Control (FCTC) guidelines.
DESIGN: German EstSmoke, an adapted version of the UK EstSmoke simulation model, applies the Markov modelling approach. Transition probabilities for (re-)currence of smoking-related disease were calculated from large German disease-specific registries and the German Health Update (GEDA 2010). Estimations of both health care costs and effect sizes of smoking cessation policies were taken from recent German studies and discounted at 3.5%/year.
SETTING: Germany PARTICIPANTS: German population of prevalent current, never and ex-smokers in 2009: 81 million MEASUREMENT: Lifetime cost and outcomes in current, never and ex-smokers FINDINGS: If tobacco control policies are not strengthened, the German smoking population will incur €41.56 billion lifetime excess costs compared with never smokers. Implementing tobacco control policies consistent with WHO FCTC guidelines would reduce the difference of lifetime costs between current smokers and ex-smokers by at least €1.7 billion.
CONCLUSIONS: Modelling suggests that the lifetime healthcare costs of people in Germany who smoke are substantially greater than those of people who have never smoked. However, more comprehensive tobacco control policies could reduce healthcare expenditure for current smokers by at least 4%.
| Original language | English |
|---|---|
| Pages (from-to) | 125-136 |
| Number of pages | 12 |
| Journal | Addiction |
| Volume | 113 |
| Issue number | 1 |
| Early online date | 22 Jul 2017 |
| DOIs | |
| Publication status | Published - Jan 2018 |
Bibliographical note
This is an author-produced version of the published paper. Uploaded in accordance with the publisher’s self-archiving policy. Further copying may not be permitted; contact the publisher for detailsKeywords
- Journal Article
- smoking cessation
- WHO FCTC
- Life-time health-care costs
- smoking-attributable diseases
- tobacco control policies
- potential cost savings
- Markov Chains
- Humans
- Middle Aged
- Male
- Stroke/economics
- Young Adult
- Computer Simulation
- Lung Neoplasms/economics
- Smoking/economics
- Adult
- Female
- Myocardial Infarction/economics
- Health Policy
- Health Care Costs
- Adolescent
- Aged
- Pulmonary Disease, Chronic Obstructive/economics
- Germany
- Smoking Cessation