Department of Health Policy and Management, School of Public Health, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia.
University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Nicotine Tob Res. 2022 Feb 1;24(2):233-240. doi: 10.1093/ntr/ntab182.
BACKGROUND/OBJECTIVES: Smoking is the leading risk factor for many chronic diseases. The quantitative analysis of potential health gains from reduced smoking is important for establishing priorities in Mongolia's health policy. This study quantifies the effect of tobacco-tax increases on future smoking prevalence and the associated smoking-related burden of disease in Mongolia.
The dynamic model for health impact assessment (DYNAMO-HIA) tool was used. The most recent data were used as input for evaluating tobacco-taxation scenarios. Demographic data were taken from the Mongolian Statistical Information Services. Smoking data came from a representative population-based STEPS survey, and smoking-related disease data were obtained from the health-information database of Mongolia's National Health Center. Simulation was used to evaluate various levels of one-time price increases on tobacco products (25% and 75%) in Mongolia. Conservative interpretation suggests that the population will eventually adjust to the higher tobacco price and return to baseline smoking behaviors.
Over a three-year period, smoking prevalence would be reduced by 1.2% points, corresponding to almost 40 thousand smokers at the population level for a price increase of 75%, compared to the baseline scenario. Projected health benefits of this scenario suggest that more than 137 thousand quality adjusted of life years would be gained by avoiding smoking-related diseases within a population of three million over a 30-year period.
Prevention through effective tobacco-control policy could yield considerable gains in population health in Mongolia. Compared to current policy, tax increases must be higher to have a significant effect on population health.
Tobacco taxation is an effective policy for reducing the harm of tobacco smoking, while benefiting population health in countries where the tobacco epidemic is still in an early stage. Smoking prevalence and smoking behaviors in these countries differ from those in Western countries. Reducing the uptake of smoking among young people could be a particularly worthwhile benefit of tobacco-tax increases.
背景/目的：吸烟是许多慢性病的主要危险因素。量化减少吸烟带来的潜在健康收益对于蒙古制定卫生政策重点具有重要意义。本研究旨在量化提高烟草税对未来吸烟流行率的影响，以及对蒙古与吸烟相关的疾病负担的影响。
使用动态健康影响评估（DYNAMO-HIA）模型。使用最新数据作为评估烟草税方案的输入。人口数据来自蒙古统计信息服务，吸烟数据来自代表性的基于人群的 STEPS 调查，与吸烟相关的疾病数据来自蒙古国家卫生中心的健康信息数据库。模拟评估了蒙古一次性提高烟草产品价格（25%和 75%）的不同水平。保守解释表明，人口最终将适应更高的烟草价格，并恢复到基线吸烟行为。
在三年内，与基线情景相比，75%的价格上涨将使吸烟流行率降低 1.2 个百分点，相当于人群层面减少近 4 万烟民。该方案预计的健康收益表明，在 30 年内，300 万人口中避免与吸烟相关的疾病将获得超过 13.7 万质量调整生命年。
通过有效的烟草控制政策进行预防，可以使蒙古的人口健康获得可观的收益。与现行政策相比，提高税收水平必须更高，才能对人口健康产生重大影响。
在烟草流行仍处于早期阶段的国家，烟草税是减少吸烟危害、造福人口健康的有效政策。这些国家的吸烟率和吸烟行为与西方国家不同。减少年轻人的吸烟率可能是提高烟草税的特别有价值的收益。
