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Costs, health effects and cost-effectiveness of alcohol and tobacco control strategies in Estonia

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  • Lai, Taavi
  • Habicht, Jarno
  • Reinap, Marge
  • Chisholm, Dan
  • Baltussen, Rob

Abstract

Objective To assess the population-level costs, effects and cost-effectiveness of different alcohol and tobacco control strategies in Estonia.Design A WHO cost-effectiveness modelling framework was used to estimate the total costs and effects of interventions. Costs were assessed in Estonian Kroon (EEK) for the year 2000, while effects were expressed in disability-adjusted life years (DALYs) averted. Regional cost-effectiveness estimates for Eastern Europe, were used as baseline and were contextualised by including country-specific input data.Results Increased excise taxes are the most cost-effective intervention to reduce both hazardous alcohol consumption and smoking: 759Â EEK ([euro]49) and 218Â EEK ([euro]14) per DALY averted, respectively. Imposing additional advertising bans would cost 1331Â EEK ([euro]85) per DALY averted to reduce hazardous alcohol consumption and 304Â EEK ([euro]19) to reduce smoking. Compared to WHO-CHOICE regional estimates, interventions were less costly and thereby more cost-effective in Estonia.Conclusions Interventions in alcohol and tobacco control are cost-effective, and broad implementation of these interventions to upgrade current situation is warranted from the economic point of view. First priority is an increase in taxation, followed by advertising bans and other interventions. The differences between WHO-CHOICE regional cost-effectiveness estimates and contextualised results underline the importance of the country level analysis.

Suggested Citation

  • Lai, Taavi & Habicht, Jarno & Reinap, Marge & Chisholm, Dan & Baltussen, Rob, 2007. "Costs, health effects and cost-effectiveness of alcohol and tobacco control strategies in Estonia," Health Policy, Elsevier, vol. 84(1), pages 75-88, November.
    • Handle: RePEc:eee:hepoli:v:84:y:2007:i:1:p:75-88
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    2. Bolin, Kristian & Borgman, Benny & Gip, Christina & Wilson, Koo, 2011. "Current and future avoidable cost of smoking – Estimates for Sweden 2007," Health Policy, Elsevier, vol. 103(1), pages 83-91.
    3. Jain, Vageesh & Crosby, Liam & Baker, Peter & Chalkidou, Kalipso, 2020. "Distributional equity as a consideration in economic and modelling evaluations of health taxes: A systematic review," Health Policy, Elsevier, vol. 124(9), pages 919-931.
    4. Hill, Sarah R. & Vale, Luke & Hunter, David & Henderson, Emily & Oluboyede, Yemi, 2017. "Economic evaluations of alcohol prevention interventions: Is the evidence sufficient? A review of methodological challenges," Health Policy, Elsevier, vol. 121(12), pages 1249-1262.

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