Cost-effectiveness of tobacco control policies in Vietnam

Objective: To analyze the cost-effectiveness of tobacco control interventions targeted at the population-level in Vietnam.

Methods: We followed up the population of 2006 to analyze the cost and health gains associated with four tobacco control interventions: excise tax increase; graphic cigarette pack warning labels; mass media campaigns; and smoking bans (in public and work places). The model was constructed such that the interventions affected the smoking uptake and cessation behaviors of the age cohorts and the resulting smoking prevalence defined their health outcomes.

Results: Amongst the examined interventions, graphic warning labels on cigarette packs was the most cost-effective option with Incremental Cost-effectiveness Ratio of VND 500 per Disability-Adjusted Life Year (DALY) averted. Excise tax increase was positioned in the second place with less than VND 8,600 per DALY averted. Mass media campaigns and smoking bans were significantly more costly than the above two interventions, with workplace bans the least cost-effective. Nonetheless all interventions fell within the definition of being “very cost-effective” according to the threshold level suggested by WHO. If we included the cost offset into our analysis, all interventions would provide cost-savings to the government health sector.

Conclusion: All four interventions examined were highly cost-effective and recommended to be considered as priorities in the context of Vietnam. The government may consider graphic warning labels and tax increase initially, followed by other interventions.