A Cost-Effectiveness Analysis of India’s 2008 Prohibition of Smoking in Public Places in Gujarat

International Journal of Environmental Research and Public Health

Elisabeth A Donaldson³  Hugh R Waters¹  Monika Arora⁴  Beena Varghese⁴  Paresh Dave² 

[1] Rand Corporation, 1776 Main Street, Room 4369, Santa Monica, CA 90401, USA; E-Mail:;State Tobacco Control Cell, Department of Health & Family Welfare, Government of Gujarat, 3rd Floor, Block No. 5/2, Dr. Jivraj Mehta Bhavan, Sector No. 10, Gandhinagar-Gujarat 382010, India; E-Mails:;Institute for Global Tobacco Control, Johns Hopkins Bloomberg School of Public Health, 627 N. Washington Street, 2nd Floor, Baltimore, MD 21205, USA;Public Health Foundation of India, Second Floor, 4/2, Sirifort Institutional Area, August Kranti Marg, New Delhi, 110016, India; E-Mails:

关键词: cost-effectiveness;    public smoking bans;    smoke free public places;    secondhand smoke;    tobacco smoking;   

DOI  :  10.3390/ijerph8051271

来源: mdpi

【 摘 要 】

Tobacco smoking and exposure to secondhand tobacco smoke are associated with disability and premature mortality in low and middle-income countries. The aim of this study was to assess the cost-effectiveness of implementing India’s Prohibition of Smoking in Public Places Rules in the state of Gujarat, compared to implementation of a complete smoking ban. Using standard cost-effectiveness analysis methods, the cost of implementing the alternatives was evaluated against the years of life saved and cases of acute myocardial infarction averted by reductions in smoking prevalence and secondhand smoke exposure. After one year, it is estimated that a complete smoking ban in Gujarat would avert 17,000 additional heart attacks and gain 438,000 life years (LY). A complete ban is highly cost-effective when key variables including legislation effectiveness were varied in the sensitivity analyses. Without including medical treatment costs averted, the cost-effectiveness ratio ranges from $2 to $112 per LY gained and $37 to $386 per acute myocardial infarction averted. Implementing a complete smoking ban would be a cost saving alternative to the current partial legislation in terms of reducing tobacco-attributable disease in Gujarat.

【 授权许可】

CC BY   
© 2011 by the authors; licensee MDPI, Basel, Switzerland.