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  • Impact of tax and tobacco-free generation on health-adjusted life years in the Solomon Islands: a multistate life table simulation

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Original research
Impact of tax and tobacco-free generation on health-adjusted life years in the Solomon Islands: a multistate life table simulation
  1. Ankur Singh1,2,
  2. Frederieke Sanne Petrović-van der Deen3,
  3. Natalie Carvalho4,5,
  4. Alan D Lopez5,
  5. Tony Blakely2,6
  1. 1 Centre for Health Equity, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
  2. 2 Population Interventions, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
  3. 3 Department of Public Health, University of Otago, Wellington, Wellington, New Zealand
  4. 4 Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
  5. 5 Global Burden of Disease Group, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
  6. 6 Burden of Disease Epidemiology, Equity and Cost-Effectiveness Programme, Department of Public Health, University of Otago, Wellington, Wellington, New Zealand
  1. Correspondence to Professor Tony Blakely, Population Interventions, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC 3010, Australia; antony.blakely{at}unimelb.edu.au

Abstract

Objective To estimate health-adjusted life years (HALY) gained in the Solomon Islands for the 2016 population over the remainder of their lives, for three interventions: hypothetical eradication of cigarettes; 25% annual tax increases to 2025 such that tax represents 70% of sales price of tobacco; and a tobacco-free generation (TFG).

Design We adapted an existing multistate life table model, using Global Burden of Disease (GBD) and other data inputs, including diseases contributing >5% of the GBD estimated disability-adjusted life years lost in the Solomon Islands in 2016. Tax effects used price increases and price elasticities to change cigarette smoking prevalence. The TFG was modelled by no uptake of smoking among those 20 years and under after 2016.

Results Under business as usual (BAU) smoking prevalence decreased over time, and decreased faster under the tax intervention (especially for younger ages). For example, for 20-year-old males the best estimated prevalence in 2036 was 22.9% under BAU, reducing to 14.2% under increased tax. Eradicating tobacco in 2016 would achieve 1510 undiscounted HALYs per 1000 people alive in 2016, over the remainder of their lives. The tax intervention would achieve 370 HALYs per 1000 (24.5% of potential health gain), and the TFG 798 HALYs per 1000 people (52.5%). By time horizon, 10.5% of the HALY gains from tax and 8.0% from TFG occur from 2016 to 2036, and the remainder at least 20 years into the future.

Conclusion This study quantified the potential of two tobacco control policies over maximum health gains achievable through tobacco eradication in the Solomon Islands.

  • low/middle-income country
  • taxation
  • surveillance and monitoring
  • endgame

https://doi.org/10.1136/tobaccocontrol-2018-054861

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    Footnotes

    • Contributors AS contributed to acquisition of data, analysis, interpretation of data and drafting of the manuscript. FSPvdD contributed to analysis, interpretation of data and providing critical feedback on the manuscript. NC contributed to interpretation of data and providing critical feedback on the manuscript. ADL contributed to conception of the project and providing critical feedback on the manuscript. TB led the conception of the project and design, analysis, interpretation of data and oversaw the drafting of the manuscript.

    • Funding Funding for this project was provided by Melbourne School of Population and Global Health, University of Melbourne, and a Health Research Council of New Zealand, Programme Grant ‘BODE3: Modelling preventive interventions to improve health and social outcomes’ (16/443).

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Ethics approval This study analysed existing publicly available modelled output data for Solomon Islands population from the Global Burden of Disease study. Ethics approval was not required as data were not collected from any participants.

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

    • Data availability statement Data are available in a public, open access repository. The data sets generated and/or analysed during the current study are available in the (IHME’s Global Burden of Disease study) repository (http://ghdx.healthdata.org/gbd-results-tool and https://cloud.ihme.washington.edu/index.php/s/jWq9BL54CcyzuMz?path=%2FGBD2016Covariates).