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Economic evaluations of tobacco control interventions in low‐ and middle‐income countries: a systematic review

Jiang, Xiaobin; Jackson, Louise J; Syed, Muslim Abbas; Avşar, Tuba Saygın; Abdali, Zainab; (2022) Economic evaluations of tobacco control interventions in low‐ and middle‐income countries: a systematic review. Addiction , 117 (9) pp. 2374-2392. 10.1111/add.15821. Green open access

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Abstract

Background and Aims: Tobacco consumption and its associated adverse outcomes remain major public health issues, particularly in low- and middle-income countries. This systematic review aimed to identify and critically assess full economic evaluations for tobacco control interventions in low- and middle-income countries. / Methods: Electronic databases, including EMBASE, MEDLINE and PsycINFO and the grey literature, were searched using terms such as ‘tobacco’, ‘economic evaluation’ and ‘smoking’ from 1994 to 2020. Study quality was assessed using the Consensus Health Economic Criteria and the Philips checklist. Studies were included which were full economic evaluations of tobacco control interventions in low- and middle-income settings. Reviews, commentaries, conference proceedings and abstracts were excluded. Study selection and quality assessment were conducted by two reviewers independently. A narrative synthesis was conducted to synthesize the findings of the studies. / Results: This review identified 20 studies for inclusion. The studies evaluated a wide range of interventions, including tax increase, nicotine replacement therapy (nicotine patch/gum) and financial incentives. Overall, 12 interventions were reported to be cost-effective, especially tax increases for tobacco consumption and cessation counselling. There were considerable limitations regarding data sources (e.g. using cost data from other countries or assumptions due to the lack of local data) and the model structure; sensitivity analyses were inadequately described in many studies; and there were issues around the transferability of results to other settings. Additionally, the affordability of the interventions was only discussed in two studies. / Conclusions: There are few high-quality studies of the cost-effectiveness of tobacco use control interventions in low- and middle-income countries. The methodological limitations of the existing literatures could affect the generalizability of the findings.

Type: Article
Title: Economic evaluations of tobacco control interventions in low‐ and middle‐income countries: a systematic review
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1111/add.15821
Publisher version: https://doi.org/10.1111/add.15821
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Substance Abuse, Psychiatry, Cost-effectiveness, economic evaluation, low- and middle-income countries, smoking cessation, tobacco control, tobacco economics
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Applied Health Research
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
URI: https://discovery.ucl.ac.uk/id/eprint/10145844
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