Estimating the Effectiveness of Health Warnings on Cigarette Packaging in Nigeria: A Modeling Study

ALCARAZ, ANDREA; ADEDEJI, ADENIRAN; PICHÓN-RIVIERE, ANDRÉS; AMARA EKERUCHE, MMA; CASARINI, AGUSTÍN; RODRÍGUEZ CAIROLI, FEDERICO; ESPINOLA, NATALIA; ROBERTI, JAVIER; PALACIOS, ALFREDO; BARDACH, ARIEL

Nicotine and Tobacco Research

Nicotine & Tobacco Research

Año: 2023

Introduction: Tobacco consumption is associated with nearly 30,000 deaths annually in Nigeria alongside other adverse health and economic effects. Our objective was to estimate the health and economic implications of the current cigarette labelling policies (text-only health warnings (HW)); new HW policies in the country (adding graphic HW with up to 60% coverage), and plain packaging policy as recommended by the World Health Organization.Methods: We used a probabilistic state-transition individual microsimulation model, considering natural history, healthcare costs, and quality-of-life losses associated with main tobacco-attributable diseases; and the potential effects of packaging and labelling policies. We used three scenarios: a) text-only HWs covering 50% of the pack, b) introduction of graphic HWs of 50% (and later increasing to 80%) of the pack, c) plain packaging with HWs covering 80% of the pack.Results: A total of 748 deaths are averted in the current situation; 7,478 and 14,208 deaths can be averted with the new policy and with plain packaging, respectively. The number of cardiac, cerebrovascular, and cancer events that could be averted by adopting text and graphic HWs are 3,093, 5,093, and 1,346, respectively; increasing to 5,876, 9,676, and 2,557, respectively, with plain packaging. Up to 251,794 years were lost due to early deaths and disability, and ₦144.6 billion (USD 469 million) in health costs could be saved with HWs covering 50% to 80% of the pack over 10 years. With plain packaging and graphic HWs covering 80% of the package 478,408 years and ₦274.7 billion (USD 895 million) would be saved.Conclusions: The new cigarette labeling policy in Nigeria may yield significant health and economic benefits over 10 years. Moving the current policy to plain packaging can significantly improve these benefits.