Health and Economic Impact of Health Warnings and Plain Tobacco Packaging in Seven Latin American Countries: Results of a Simulation Model

ALCARAZ, ANDREA; HERNÁNDEZ-VÁSQUEZ, AKRAM; PALACIOS, ALFREDO; RODRÍGUEZ, BELÉN; ROBERTI, JAVIER; GARCÍA-MARTÍ, SEBASTIÁN; CIAPPONI, AGUSTÍN; AUGUSTOVSKI, FEDERICO; BARDACH, ARIEL; PICHON-RIVIERE, ANDRÉS

Nicotine & Tobacco Research

Oxford Academic

Lugar: Londres; Año: 2020

Introduction: The burden of disease attributable to tobacco use in Latin America is very high. Our objective was to evaluate the 10-year potential impact of current legislation related to cigarette packaging and warnings and expected effects of moving to a higher level of strategies implementing cigarette plain packaging on health and cost outcomes in Argentina, Bolivia, Brazil, Chile, Colombia, Mexico, and Peru, using a microsimulation model.Methods: We used a probabilistic state-transition microsimulation model, considering natural history, costs and quality of life losses associated with main tobacco-related diseases. We followed up individuals in hypothetical cohorts and calculated health outcomes annually to obtain aggregated long-term population health outcomes and costs. We performed a literature review to estimate effects. and analysed studies and information from ministries, relevant organizations, and national surveys. We calibrated the model comparing the predicted disease specific mortality rates with local statistics.Results: Current graphic warnings already in place in each country could avert, over 10 years, 69,369 deaths and 638,295 disease events, adding 1.2 million years of healthy life and saving USD 5.3 billion in the seven countries. If these countries implemented plain packaging strategies, additional 155,857 premature deaths and 4,133,858 events could be averted, adding 4.1 million healthy years of life and saving USD 13.6 billion in direct healthcare expenses of diseases attributable to smoking.Conclusion: Latin American countries should not delay the implementation of this strategy that will alleviate part of the enormous health and financial burden that tobacco poses on their economies and healthcare systems.