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从多个角度看持续开展的全国性控烟媒体宣传活动对减少吸烟危害的预算影响。

Budgetary impact from multiple perspectives of sustained antitobacco national media campaigns to reduce the harms of cigarette smoking.

作者信息

Maciosek Michael V, Armour Brian S, Babb Stephen D, Dehmer Steven P, Grossman Elizabeth S, Homa David M, LaFrance Amy B, Rodes Robert, Wang Xu, Xu Zack, Yang Zhuo, Roy Kakoli

机构信息

HealthPartners Institute, Bloomington, Minnesota, USA

Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.

出版信息

Tob Control. 2020 Apr 27. doi: 10.1136/tobaccocontrol-2019-055482.

Abstract

BACKGROUND

High-intensity antitobacco media campaigns are a proven strategy to reduce the harms of cigarette smoking. While buy-in from multiple stakeholders is needed to launch meaningful health policy, the budgetary impact of sustained media campaigns from multiple payer perspectives is unknown.

METHODS

We estimated the budgetary impact and time to breakeven from societal, all-payer, Medicare, Medicaid and private insurer perspectives of national antitobacco media campaigns in the USA. Campaigns of 1, 5 and 10 years of durations were assessed in a microsimulation model to estimate the 10 and 20-year health and budgetary impact. Simulation model inputs were obtained from literature and both pubic use and proprietary data sets.

RESULTS

The microsimulation predicts that a 10-year national smoking cessation campaign would produce net savings of $10.4, $5.1, $1.4, $3.6 and $0.2 billion from the societal, all-payer, Medicare, Medicaid and private insurer perspectives, respectively. National antitobacco media campaigns of 1, 5 and 10-year durations could produce net savings for Medicaid and Medicare within 2 years, and for private insurers within 6-9 years. A 10-year campaign would reduce adult cigarette smoking prevalence by 1.2 percentage points, prevent 23 500 smoking-attributable deaths over the first 10 years. In sensitivity analysis, media campaign costs would be offset by reductions in medical care spending of smoking among all payers combined within 6 years in all tested scenarios.

CONCLUSIONS

1, 5 and 10-year antitobacco media campaigns all yield net savings within 10 years from all perspectives. Multiyear campaigns yield substantially higher savings than a 1-year campaign.

摘要

背景

高强度反烟草媒体宣传活动是减少吸烟危害的一项行之有效的策略。虽然需要多个利益相关者的支持才能推出有意义的卫生政策,但从多个支付方角度来看,持续进行媒体宣传活动的预算影响尚不清楚。

方法

我们从美国全国反烟草媒体宣传活动的社会、所有支付方、医疗保险、医疗补助和私人保险公司等角度,估计了预算影响和收支平衡时间。在一个微观模拟模型中评估了为期1年、5年和10年的宣传活动,以估计10年和20年的健康和预算影响。模拟模型的输入数据来自文献以及公共使用数据集和专有数据集。

结果

微观模拟预测,从社会、所有支付方、医疗保险、医疗补助和私人保险公司角度来看,一项为期10年的全国戒烟宣传活动将分别产生104亿美元、51亿美元、14亿美元、36亿美元和2亿美元的净节省。为期1年、5年和10年的全国反烟草媒体宣传活动可在2年内为医疗补助和医疗保险带来净节省,在6至9年内为私人保险公司带来净节省。一项为期10年的宣传活动将使成人吸烟率降低1.2个百分点,在最初10年内预防23500例与吸烟相关的死亡。在敏感性分析中,在所有测试情景下,媒体宣传活动成本将在6年内被所有支付方因吸烟导致的医疗支出减少所抵消。

结论

从所有角度来看,为期1年、5年和10年的反烟草媒体宣传活动在10年内均产生净节省。多年期宣传活动产生的节省远高于为期1年的宣传活动。

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