Background: The burden of disease attributable
to tobacco use in Latin America is very high. The objective of this study was
to evaluate the potential impact of implementing cigarette plain packaging
(PP), 100% smoke-free environments (SFE) and complete ban on advertising,
promotion and sponsorship of tobacco (BAPS) in Argentina, Bolivia, Brazil,
Chile, Colombia, Mexico and Peru.
Methods: A mathematical model was used to
estimate the chances people have to get sick or die because of 17 smoking-related
conditions. A systematic review was carried out to identify
the epidemiological and cost data relevant to each country, as well as the
effectiveness of the interventions. The model considered each country's
legislation and level of compliance for each intervention. Then, we modeled the
expected impact on health and costs of different potential scenarios for these
interventions.
Results: We estimated the following benefits
for all seven countries: PP could avoid 204 073 deaths, 212 867 cardiovascular
events, 26 456 cancer diagnoses, 99 784 COPD cases, and 23 739 USD on direct medical costs in the next ten years. 100% SFE could lead to avoid
150 361 deaths, 247 171 cardiovascular events, 77 400 cancers and 311 129 COPD
cases, and 15 413 USD on direct medical costs in the next ten years. 100% BAPS
could save 86 911 deaths, 327 390 cardiovascular events, 38 883 cancers, 142 104
COPD cases, and 10 505 USD on direct medical cost to the health system in the
next ten years. Different scenarios were modeled for each country. An example-the
case for Colombia- is shown in the table.
COLOMBIA | Medium warnings | Strong warnings | Plain packaging | 100% SFE
(LoC: 50%) | 100% SFE
(LoC: 100%) | Complete BAPS
(LoC: 75%) | Complete BAPS
(LoC: 100%) |
Avoided deaths | 3465 | 7038 | 24 086 | 11035 | 18 151 | 7 797 | 10584 |
Avoided events | 22 775 | 46 256 | 158 300 | 72 524 | 119 293 | 60 961 | 69 561 |
Avoided costs (USD millions) | 196 | 399 | 1 365 | 625 | 1 029 | 442 | 600 |
USD, United States dollars. 1 USD = 2743,39 Colombian pesos (December, 2015). SFE, Smoke-Free Environment. BAPS, Ban on Advertising, Promotion and Sponsorship of tobacco. LoC, Level of Compliance. |
[Potential impact of different scenarios, Colombia]Conclusions: The potential impact of fully implementing PP,
100% SFE and BAPS could avoid a large burden of disease and costs for the
health systems in Latin America. This information could be useful for decision
makers to promote these policies.