Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #109980

Subramony Subramonia-Iyer, MD, MPH, Institute of Public Health, Eastern Region Public Health Observatory, Robinson Way, Cambridge, CB2 2SR, United Kingdom, 0044 1223 330165, ss_mony@yahoo.co.uk and John Powles, MD, MPH, Institute of Public Health, Department of Public Health and Primary Care, Robinson Way, Cambridge, CB2 2SR, United Kingdom.

Introduction & Methods:

The decline in smoking in England & Wales stabilised during the 1990s. We explored the potential consequences of 3 hypothetical scenarios using the ‘PREVENT' program:

1.“Plateau”: indefinite persistence of the smoking prevalence in 1994.

2.“Continuation” of the pre-1994 rate of reduction of through the 1990s.

3.“Resumption”: the prevalence remains constant from 1994 to 2004, and then starts decreasing at pre-1994 rates.

12% prevalence was chosen as the feasible minimum.

Results:

In the continuation scenario, a maximum of 8000 male and 7000 female deaths could have been avoided annually, by 2030 – relative to plateau scenario. The resumption scenario would achieve 12% population prevalence by 2037, and avoid 8500 male and 7200 female deaths in 2035. The actual years of life gained, reach an annual maximum of 340,000 for men and 280,000 for women by 2068. This represents the avoidable disease burden due to continued high smoking prevalence.

The estimated value of life years gained, assigning a value of £30,000 ($55,500) per life year, and 5% discounting, indicates that the failure to maintain reduction in smoking prevalence may have led to a loss of £157.8 ($ 290.1) billion till 2068. Achievement of the resumption scenario may generate potential gains up to £101.5 ($187.8) billion (2004- 2068).

Discussion:

The policies which facilitate resumption scenario are discussed. ‘PREVENT' provides a heuristic method for the estimation of disease burden due to smoking prevalence. Although not exact, these results, being superior to intuitive judgments and qualitative assessments, can inform better policymaking.

Learning Objectives: Upon completing this session, participants will be able to

• Identify adverse trends in risk factor prevalence.
• Construct appropriate counterfactuals to compare the effects of alternate scenarios.
• Describe the steps involved in modelling to assess the magnitude of these effects.
• Discuss the results with the aim of influencing policy, to reduce the prevalence of risk factor, using the example of smoking.

Keywords: Smoking, Tobacco

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

Recorded presentation