A Brunel University-led project to develop a decision-support tool comparing the cost of anti-smoking interventions with savings to the local economy and the wider health sector will be rolled out in countries across Europe following a funding grant of over €2 million.
The economic cost of tobacco smoking in Europe is an estimated €98-130 billion each year – just above 1% of the EU Gross Domestic Product – and despite a decrease in the number of tobacco smokers over the last 30 years, smoking still kills about 700,000 people each year in Europe alone. Smoking not only affects the health and wellbeing of three in ten EU adults, but a similar number of children start to smoke before the age of 18*.
In the current economic climate, local authorities are facing new challenges to balance public health measures such as tobacco control, which cost money in the short term, with economic returns which may only be realised over many years. The new Brunel-developed tool is designed to measure the return on investment of tobacco intervention packages at a local rather than national level, allowing local governments – which now have responsibility for public health – the flexibility to weigh and to justify costs against savings and to examine the effectiveness of current practice to maximise returns.
A simple interface allows users to alter investment in different intervention strategies, such as nicotine replacement therapies, behavioural support, and advertising to deter potential new smokers, and models the resulting effect on costs to the local economy and to the wider health and social care sector in the short, medium and long term. The tool is already in use by local authorities around the UK and is unique in its local specificity, with users drawing on particular local circumstances, statistics and datasets to create the most accurate model possible.
A team of Brunel academics led by Dr Subhash Pokhrel from the Health Economics and Research Group (HERG) published the first generation tool in 2011 with funding from Tobacco Free Futures, Fresh North East and Smokefree South West. Dr Pokhrel recalls: “The Coalition Government had just published the White Paper indicating that public health responsibility would fall under local authorities, and because we were already in an economically austere climate, the demand for such a tool suddenly increased”. In 2012, Dr Pokhrel’s team worked with the National Institute for Health and Care Excellence (NICE) to develop a second generation tool, and a multidisciplinary consortium was formed representing several EU countries to put together the funding proposal to expand the research onto the continent.
As the European leader on tobacco control, the UK faces different challenges than other EU countries where smoking prevalence may be much higher. The €2,047,908, three-year grant from the EU’s Framework Programme 7 will help the team understand how the tool can be co-created in a number of other European countries and how tobacco control policy implications can be translated across EU borders.
“The value of the project has been hugely increased by austerity measures across the EU and it has been developed in that context,” explains Dr Pokhrel. “It’s important to make short term losses explicit and to compare them against long term gains. Similar tools have been commissioned recently by NICE regarding alcohol and physical activity – this is a new outlook on healthcare intervention funding.”
*Figures taken from ‘The Economic Argument’, by Dr Subhash Pokhrel and Dr Lesley Owen, in Pan European Networks: Science and Technology 07
Consortium members: Brunel University, London, UK; Maastricht University, the Netherlands; Helmholtz Zentrum Munich, Germany; Syreon Research Institute, Hungary; Pompeu Fabra University, Spain; National Institute for Health and Care Excellence, UK; Lelan Ltd, UK; European Network for Smoking and Tobacco Prevention, Belgium; National Centre for Smoking Cessation and Training, UK; Agency for Quality and Accreditation in Health Care and Social Welfare , Croatia; National Health Service Commissioning Board, UK