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Helping policymakers stub out smoking

Impact case study for REF 2021: Allied Health Professions, Dentistry, Nursing and Pharmacy (UoA 03)

The year was 2012. Despite strong words from health professionals and stringent measures from governments around the world, tobacco-related illnesses were still claiming millions of lives and costing taxpayers billions.

Statistics on tobacco costs in the world and the EU

Policymakers started to wonder what the alternative strategy was. Whilst the number of smokers was falling, they weren’t falling fast enough – 20 per cent of Brits were still puffing away – with the resulting poor health creating a significant burden for health services. Was there a new strategy that would both get more people to quit, and be more cost-effective?

To help the policymakers develop their new strategies, researchers from Brunel University London’s Health Economics Research Group began to develop tools that would allow the policymakers to answer three key questions: What new areas should we invest in? What existing areas should we invest more in? And what areas do we disinvest from?

The Brunel team’s new tools allowed policy makers to gain a better understanding of what measures would give them a better Return on Investment (ROI):

Calculating Return on Investment (ROI) for smoking interventions

The researchers worked with local, regional and national policymakers from around Europe to help them understand where they should be spending their money, and what each possible investment might recoup in the long term in the form of lower healthcare costs, increased productivity and reduced demand for social care.

The tools were adaptable and considered local conditions, such as the general make-up of the population and how many of them smoke or used to smoke, and what intervention measures were available to policymakers, how effective each one was, and how much each one cost.

Return on investment for smoking treatments

The policymakers were able to develop a variety of successful measures thanks to the work of Brunel’s health economists, and there are now lives being saved because those that decide where the money gets spent have the tools to show them what works.

Meet the Principal Investigator(s) for the project

Professor Subhash Pokhrel - Subhash is a professor of health economics and the Head of Department of Health Sciences and the Lead of the Health Economics Research Group (HERG). Subhash's research has contributed to several public health policies. The suite of NICE Public Health ROI Tools – which provided the basis for many public health investment decisions in England - was informed by the work on tobacco control led by Subhash. The ROI tools are practical, customisable models to help make real-world decisions in context of local government decision-making. Economic arguments are needed to make the business case for public health investments. Subhash led the roll out of ROI work to several European nations through a €2 million multi-centre European Commission funded study, EQUIPT. He has been the coordinator of a large scale inter-disciplinary collaboration of national and international expertise. Subhash is the lead author of a book, ROI in Public Health Policy: Supporting Decision Making (Palgrave Macmillan). Subhash’s work in public health research has been as diverse as the discipline itself – from developing a household decision making pathway for child health care in low- and middle income countries (LMICs) to quantifying the economic impact of breastfeeding promotion in industrialised countries; from evaluating health insurance for its population health impact in LMICs to finding out what interventions improve physical activity globally. Subhash is intrigued by the following question: In LMICs and industrialised countries, what works to improve population health outcomes and at what cost? Google Profile Orcid Profile ResearchGate BURA Profile https://www.brunel.ac.uk/about/chmls/health-sciences

Related Research Group(s)

Health Economics (HERG)

Health Economics (HERG) - Our strategic focus is on economic evaluation and systematic reviews of a broad range of clinical and health service technologies by providing high-quality, applied, policy-relevant research, as well as developing and refining methods to increase the rigour and relevance of such studies.

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Project last modified 11/05/2022