Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Lisboa, Portugal.
Department of Public Health, Academic Medical Center, University of Amsterdam, Netherlands.
Eur J Public Health. 2018 Feb 1;28(1):39-43. doi: 10.1093/eurpub/ckx215.
Consistent evidence shows the importance of preventing smoking at young ages, when health behaviours are formed, with long-term consequences on health and survival. Although tobacco control policies and programmes targeting adolescents are widely promoted, the cost-effectiveness of such interventions has not been systematically documented. We performed a systematic review on the cost-effectiveness of policies and programmes preventing tobacco consumption targeting adolescents.
We systematically reviewed literature on the (i) cost and effectiveness of (ii) prevention policies targeting (iii) smoking by (iv) adolescents. PubMed, Web of Science, Cochrane, CEA-TUFTS, Health Economic Evaluations, Wiley Online Library, Centre for Reviews and Dissemination Database, the National Institute for Health and Care Excellence and Google Scholar databases were used, and Google search engine was used for other grey literature review.
We obtained 793 full-text papers and 19 grey literature documents, from which 16 studies fulfilled the inclusion criteria. Of these, only one was published in the last 5 years, and 15 were performed in high-income countries. Eight analyzed the cost-effectiveness of school-based programmes, five focused on media campaigns and three on legal bans. Policies and programmes were found to be cost-effective in all studies, and both effective and cost-saving in about half of the studies.
Evidence is scarce and relatively obsolete, and rarely focused on the evaluation of legal bans. Moreover, no comparisons have been made between different interventions or across different contexts and implementation levels. However, all studies conclude that smoking prevention policies and programmes amongst adolescents are greatly worth their costs.
有充分证据表明，在青少年时期养成健康行为时，预防吸烟至关重要，因为这对他们的健康和生存有着长期影响。尽管针对青少年的烟草控制政策和计划得到广泛推广，但这些干预措施的成本效益尚未得到系统记录。我们对预防青少年吸烟的政策和计划的成本效益进行了系统评价。
我们系统地回顾了针对青少年的（i）预防吸烟的（ii）成本和效果（iii）的政策和计划（iv）的文献。使用了 PubMed、Web of Science、Cochrane、CEA-TUFTS、卫生经济评估、Wiley Online Library、中心审查和传播数据库、国家卫生与保健卓越研究所和 Google 学术数据库，并使用 Google 搜索引擎进行了其他灰色文献综述。
我们共获得了 793 篇全文论文和 19 篇灰色文献，其中有 16 项研究符合纳入标准。其中，只有一项是在过去 5 年内发表的，15 项是在高收入国家进行的。八项研究分析了基于学校的计划的成本效益，五项研究集中在媒体宣传活动上，三项研究侧重于法律禁令。所有研究都发现政策和计划具有成本效益，约有一半的研究具有有效性和成本节约。
证据稀缺且相对陈旧，很少关注法律禁令的评估。此外，不同干预措施或不同背景和实施水平之间的比较也很少进行。然而，所有研究都得出结论，预防青少年吸烟的政策和计划非常值得投入成本。
