HealthPartners Institute, Minneapolis, Minnesota, United States of America.
ClearWay Minnesota, Minneapolis, Minnesota, United States of America.
PLoS One. 2020 Mar 18;15(3):e0230364. doi: 10.1371/journal.pone.0230364. eCollection 2020.
Tobacco control programs and policies reduce tobacco use and prevent health and economic harms. The majority of tobacco control programs and policies in the United States are implemented at local and state levels. Yet the literature on state-level initiatives reports a limited set of outcomes. To facilitate decision-making that is increasingly focused on costs, we provide estimates of a broader set of measures of the impact of tobacco control policy, including smoking prevalence, disease events, deaths, medical costs, productivity and tobacco tax revenues, using the experience of Minnesota as an example.
Using the HealthPartners Institute's ModelHealth™: Tobacco MN microsimulation, we assessed the impact of the stream of tobacco control expenditures and cigarette price increases from 1998 to 2017. We simulated 1.3 million individuals representative of the Minnesota population.
The simulation estimated that increased expenditures on tobacco control above 1997 levels prevented 38,400 cancer, cardiovascular, diabetes and respiratory disease events and 4,100 deaths over 20 years. Increased prices prevented 14,600 additional events and 1,700 additional deaths. Both the net increase in tax revenues and the reduction in medical costs were greater than the additional investments in tobacco control.
Combined, the policies address both short-term and long-term goals to reduce the harms of tobacco by helping adults who wish to quit smoking and deterring youth from starting to smoke. States can pay for initial investments in tobacco control through tax increases and recoup those investments through reduced expenditures on medical care.
烟草控制计划和政策可减少烟草使用并预防健康和经济危害。美国的大多数烟草控制计划和政策都是在地方和州一级实施的。然而，关于州级计划的文献报告显示，其结果有限。为了促进越来越注重成本的决策，我们提供了更广泛的烟草控制政策影响措施的估计，包括吸烟流行率、疾病事件、死亡、医疗费用、生产力和烟草税收，以明尼苏达州为例。
使用 HealthPartners Institute 的 ModelHealth™：Tobacco MN 微观模拟，我们评估了从 1998 年到 2017 年的烟草控制支出和卷烟价格上涨的影响。我们模拟了 130 万代表明尼苏达州人口的个人。
模拟结果估计，1997 年以来，增加的烟草控制支出可预防 20 年内 38400 例癌症、心血管疾病、糖尿病和呼吸系统疾病事件以及 4100 例死亡。价格上涨又预防了 14600 次额外的事件和 1700 次额外的死亡。税收净增加和医疗成本降低都大于烟草控制的额外投资。
这些政策共同实现了短期和长期目标，通过帮助希望戒烟的成年人和阻止年轻人开始吸烟，减少烟草的危害。各州可以通过提高税收来为烟草控制的初始投资提供资金，并通过减少医疗支出来收回这些投资。
