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Modelling the impact of plain packaging of tobacco products on cardiovascular disease in Argentina
  1. M. Victoria Salgado1,2,
  2. Joanne Penko3,4,
  3. Alicia Fernandez3,5,
  4. Raul Mejia1,6
  1. 1 Área de Salud, Economía y Sociedad, Centro de Estudios de Estado y Sociedad, Ciudad de Buenos Aires, Argentina
  2. 2 Servicio de Medicina Familiar, Hospital SAMIC El Calafate, El Calafate, Argentina
  3. 3 Center for Vulnerable Populations, University of California San Francisco, San Francisco, California, USA
  4. 4 Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA
  5. 5 Department of Medicine, University of California San Francisco, San Francisco, California, USA
  6. 6 Programa de Medicina Interna General, Hospital de Clinicas Jose de San Martin, Buenos Aires, Argentina
  1. Correspondence to Dr M. Victoria Salgado, Centro de Estudios de Estado y Sociedad, Ciudad de Buenos Aires, C1173 AAA, Argentina; victoria.salgado{at}cedes.org

Abstract

Introduction Tobacco packaging design is conceived to be attractive. Plain packaging of tobacco products reduces this attractiveness by standardising their shape, size, font and colours.

Methods To evaluate the effect of applying plain packaging to tobacco products on cardiovascular events and mortality in Argentina, we used the Cardiovascular Disease Policy Model–Argentina, a local adaptation of a well-established computer simulation model that projects cardiovascular and mortality events for the population 35–94 years old using local demographic and consumption data, during the period 2015–2024. After a literature review, we estimated that the implementation of plain packaging of tobacco products would result in an absolute decrease in tobacco prevalence of 0.55% (base-case scenario) and performed a sensitivity analysis assuming a higher and lower decrease of 1.01% and 0.095%, respectively.

Results Over the 2015–2024 period, the decrease in smoking prevalence associated with plain packaging (0.55%) is projected to avert 1880 myocardial infarctions (MI), 820 strokes and 4320 total deaths in Argentina. The higher estimate of smoking prevalence reduction (1.01%) would translate into 3450 fewer MIs, 1490 fewer strokes and 7920 fewer deaths, while the lower estimate of smoking prevalence reduction (0.095%) would result in 330 fewer MIs, 140 fewer strokes and 750 fewer deaths.

Conclusions The implementation of plain packaging of tobacco products could reduce cardiovascular events in Argentina, even in the absence of other tobacco control measures. Actual health benefits are likely higher than those presented here, since plain packaging may be most impactful by preventing young people from initiating smoking.

  • packaging and labelling
  • public policy
  • low/middle income country

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Footnotes

  • Contributors All listed authors have contributed to the intellectual content of this manuscript including study design, procedures, interpretation and analyses and writing and reviewing the paper.

  • Funding Observatorio de Salud del Grupo de Fundaciones y Empresas, Argentina.

  • Competing interests No, there are no competing interests.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.