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[巴拉圭因烟草使用导致的疾病负担,以及通过征税提高烟草价格对健康和经济的潜在影响]

[Burden of disease attributable to tobacco use in Paraguay, and potential health and financial impact of increasing prices through taxing].

作者信息

Bardach Ariel, Cañete Felicia, Sequera Víctor Guillermo, Palacios Alfredo, Alcaraz Andrea, Rodríguez Belén, Caporale Joaquín, Augustovski Federico, Pichon-Riviere Andrés

机构信息

Instituto de Efectividad Clínica y Sanitaria (CONICET). Buenos Aires, Argentina.

Dirección de Vigilancia de Enfermedades No Transmisibles, Ministerio de Salud Pública y Bienestar Social. Asunción, Paraguay.

出版信息

Rev Peru Med Exp Salud Publica. 2018 Oct-Dec;35(4):599-609. doi: 10.17843/rpmesp.2018.354.3708.

Abstract

OBJECTIVES

To consider the burden of disease associated to tobacco consumption in Paraguay and to evaluate the potential economic and health effect of price increase through taxes.

MATERIALS AND METHODS

A Monte Carlo simulation model was designed incorporating natural history, costs, and quality of life of diseases associated to smoking for 2015. Also, several scenarios were considered for the impact of tax raises on the prevalence of smoking and fiscal collection.

RESULTS

In Paraguay, 3,354 people die every year as a consequence of smoking. Nineteen percent of deaths are due to cardiac ischemia, 15% due to stroke. 77% of deaths due to chronic obstructive pulmonary disease (COPD), and 83% of lung cancer can be attributed to smoking. These diseases in Paraguay represent an annual direct medical cost of more than 1.5 trillion PYG, while the tax collection from cigarette sales barely covers 20% of this expense. A 50% increase in the price of cigarettes via taxes could avoid 2507 deaths in ten years and generate resources by 2.4 trillion in savings in health expenses and tax of collection.

CONCLUSIONS

The cost and the burden of disease associated to tobacco consumption is high in the health system in Paraguay. An increase in cigarette price through taxes could have significant health benefits and could offset health costs in part.

摘要

目标

考量巴拉圭与烟草消费相关的疾病负担,并评估通过税收提高烟草价格可能产生的经济和健康影响。

材料与方法

设计了一个蒙特卡洛模拟模型,纳入2015年与吸烟相关疾病的自然病史、成本和生活质量。还考虑了多种税收提高对吸烟流行率和财政收入影响的情景。

结果

在巴拉圭,每年有3354人因吸烟死亡。19%的死亡归因于心肌缺血,15%归因于中风。77%的慢性阻塞性肺疾病(COPD)死亡以及83%的肺癌死亡可归因于吸烟。这些疾病在巴拉圭每年造成的直接医疗成本超过1.5万亿瓜拉尼,而香烟销售的税收仅能覆盖这一费用的20%。通过税收使香烟价格提高50%,十年内可避免2507人死亡,并通过节省医疗费用和税收产生2.4万亿的资源。

结论

在巴拉圭的卫生系统中,与烟草消费相关的疾病成本和负担很高。通过税收提高香烟价格可能会带来显著的健康益处,并能部分抵消医疗成本。

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