Evaluating smoking control policies in the e-cigarette era: a modelling study.

Abstract:

BACKGROUND:In jurisdictions in which electronic cigarettes are currently prohibited, policy makers must weigh the potentially lower risk compared with conventional cigarettes against the risk of initiation of e-cigarettes among non-smokers. METHODS:We simulated a synthetic population over a 50-year time horizon with an open cohort model using data from Singapore, a country where e-cigarettes are currently prohibited, and data from the USA, the UK and Japan. Using the smoking prevalence and the quality-adjusted life year gained calculated, we compared tobacco control policies without e-cigarettes-namely, raising the minimum legal age (MLA), introducing a smoke-free generation (SFG) and tax rises on tobacco consumption-with policies legalising e-cigarettes, either taking a laissez-faire approach or under some form of restriction. We also evaluated combinations of these policies. RESULTS:Regardless of the country informing the transition probabilities to and from e-cigarette use in Singapore, a laissez-faire e-cigarette policy could reduce the smoking prevalence in the short term, but it is not as effective as other policies in the long term. The most effective single policies evaluated were SFG and aggressive tax rises; the most effective combination of policies considered was MLA plus moderate tax rises and e-cigarettes on prescription. CONCLUSION:Policy makers in jurisdictions in which e-cigarettes are not yet established may be advised not to prioritise e-cigarettes in their tobacco end-game strategy, unless their use can be restricted to current smokers seeking to quit.

journal_name

Tob Control

journal_title

Tobacco control

authors

Doan TTT,Tan KW,Dickens BSL,Lean YA,Yang Q,Cook AR

doi

10.1136/tobaccocontrol-2019-054951

subject

Has Abstract

pub_date

2020-09-01 00:00:00

pages

522-530

issue

5

eissn

0964-4563

issn

1468-3318

pii

tobaccocontrol-2019-054951

journal_volume

29

pub_type

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