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dc.contributor.author
Pichón-riviere, Andres
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Alcaraz, Andrea
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Palacios, Alfredo
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Rodríguez, Belén
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Reynales Shigematsu, Luz Myriam
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Pinto, Márcia
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Castillo Riquelme, Marianela
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Peña Torres, Esperanza
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Osorio, Diana Isabel
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Huayanay, Leandro
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Loza Munarriz, Cesar
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Sáenz de Miera-Juárez, Belén
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Gallegos Rivero, Verónica
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De La Puente, Catherine
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Navia Bueno, María del Pilar
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Caporale, Joaquín
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Roberti, Javier Eugenio
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Virgilio, Sacha Alexis
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Augustovski, Federico Ariel
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Bardach, Ariel Esteban
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dc.date.available
2021-10-04T13:36:16Z
dc.date.issued
2020-10
dc.identifier.citation
Pichón-riviere, Andres; Alcaraz, Andrea; Palacios, Alfredo; Rodríguez, Belén; Reynales Shigematsu, Luz Myriam; et al.; The health and economic burden of smoking in 12 Latin American countries and the potential effect of increasing tobacco taxes: an economic modelling study; Elsevier; The Lancet Global Health; 8; 10; 10-2020; e1282-e1294
dc.identifier.issn
2214-109X
dc.identifier.uri
http://hdl.handle.net/11336/142426
dc.description.abstract
Background: Worldwide, smoking tobacco causes 7 million deaths annually, and this toll is expected to increase, especially in low-income and middle-income countries. In Latin America, smoking is a leading risk factor for death and disability, contributes to poverty, and imposes an economic burden on health systems. Despite being one of the most effective measures to reduce smoking, tobacco taxation is underused and cigarettes are more affordable in Latin America than in other regions. Our aim was to estimate the tobacco-attributable burden on mortality, disease incidence, quality of life lost, and medical costs in 12 Latin American countries, and the expected health and economic effects of increasing tobacco taxes. Methods: In this modelling study, we developed a Markov probabilistic microsimulation economic model of the natural history, medical costs, and quality-of-life losses associated with the most common tobacco-related diseases in 12 countries in Latin America. Data inputs were obtained through a literature review, vital statistics, and hospital databases from each country: Argentina, Bolivia, Brazil, Chile, Colombia, Costa Rica, Ecuador, Honduras, Mexico, Paraguay, Peru, and Uruguay. The main outcomes of the model are life-years, quality-adjusted life-years, disease events, hospitalisations, disease incidence, disease cost, and healthy years of life lost. We estimated direct medical costs for each tobacco-related disease included in the model using a common costing methodology for each country. The disease burden was estimated as the difference in disease events, deaths, and associated costs between the results predicted by the model for current smoking prevalence and a hypothetical cohort of people in each country who had never smoked. The model estimates the health and financial effects of a price increase of cigarettes through taxes, in terms of disease and health-care costs averted, and increased tax revenues. Findings: In the 12 Latin American countries analysed, we estimated that smoking is responsible for approximately 345 000 (12%) of the total 2 860 921 adult deaths, 2·21 million disease events, 8·77 million healthy years of life lost, and $26·9 billion in direct medical costs annually. Health-care costs attributable to smoking were estimated to represent 6·9% of the health budgets of these countries, equivalent to 0·6% of their gross domestic product. Tax revenues from cigarette sales cover 36·0% of the estimated health expenditures caused by smoking. We estimated that a 50% increase in cigarette price through taxation would avert more than 300 000 deaths, 1·3 million disease events, gain 9 million healthy life-years, and save $26·7 billion in health-care costs in the next 10 years, with a total economic benefit of $43·7 billion. Interpretation: Smoking represents a substantial health and economic burden in these 12 countries of Latin America. Tobacco tax increases could successfully avert deaths and disability, reduce health-care spending, and increase tax revenues, resulting in large net economic benefits.
dc.format
application/pdf
dc.language.iso
eng
dc.publisher
Elsevier
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dc.rights
info:eu-repo/semantics/openAccess
dc.rights.uri
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
dc.subject
Tabaco
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Impuestos
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América Latina
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Argentina
dc.subject.classification
Epidemiología
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dc.subject.classification
Ciencias de la Salud
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dc.subject.classification
CIENCIAS MÉDICAS Y DE LA SALUD
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dc.title
The health and economic burden of smoking in 12 Latin American countries and the potential effect of increasing tobacco taxes: an economic modelling study
dc.type
info:eu-repo/semantics/article
dc.type
info:ar-repo/semantics/artículo
dc.type
info:eu-repo/semantics/publishedVersion
dc.date.updated
2021-09-07T14:58:29Z
dc.journal.volume
8
dc.journal.number
10
dc.journal.pagination
e1282-e1294
dc.journal.pais
Reino Unido
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dc.journal.ciudad
Londres
dc.description.fil
Fil: Pichón-riviere, Andres. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; Argentina
dc.description.fil
Fil: Alcaraz, Andrea. Instituto de Efectividad Clínica y Sanitaria; Argentina
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Fil: Palacios, Alfredo. Instituto de Efectividad Clínica y Sanitaria; Argentina
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Fil: Rodríguez, Belén. Instituto de Efectividad Clínica y Sanitaria; Argentina
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Fil: Reynales Shigematsu, Luz Myriam. Instituto Nacional de Salud Pública; México
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Fil: Pinto, Márcia. Fundación Oswaldo Cruz; Brasil
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Fil: Castillo Riquelme, Marianela. Ministerio de Salud; Chile
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Fil: Peña Torres, Esperanza. Instituto de Evaluación Tecnológica En Salud; Colombia
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Fil: Osorio, Diana Isabel. Instituto de Evaluación Tecnológica en Salud; Colombia
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Fil: Huayanay, Leandro. Universidad Peruana Cayetano Heredia; Perú
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Fil: Loza Munarriz, Cesar. Universidad Peruana Cayetano Heredia; Perú
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Fil: Sáenz de Miera-Juárez, Belén. Universidad Autónoma de Baja California Sur; México
dc.description.fil
Fil: Gallegos Rivero, Verónica. Centro Nacional de Excelencia Tecnológica en Salud; México
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Fil: De La Puente, Catherine. Universidad de La Frontera; Chile
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Fil: Navia Bueno, María del Pilar. Universidad Mayor de San Andrés; Bolivia
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Fil: Caporale, Joaquín. Instituto de Efectividad Clínica y Sanitaria; Argentina
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Fil: Roberti, Javier Eugenio. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; Argentina
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Fil: Virgilio, Sacha Alexis. Instituto de Efectividad Clínica y Sanitaria; Argentina
dc.description.fil
Fil: Augustovski, Federico Ariel. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; Argentina
dc.description.fil
Fil: Bardach, Ariel Esteban. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; Argentina
dc.journal.title
The Lancet Global Health
dc.relation.alternativeid
info:eu-repo/semantics/altIdentifier/doi/http://dx.doi.org/10.1016/S2214-109X(20)30311-9
dc.relation.alternativeid
info:eu-repo/semantics/altIdentifier/url/https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(20)30311-9/fulltext
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