{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T09:00:51Z","timestamp":1740128451921,"version":"3.37.3"},"reference-count":39,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2023,7,21]],"date-time":"2023-07-21T00:00:00Z","timestamp":1689897600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Mongolian government and the UMCG"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,9,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>The aim of this study is to quantify the cost-effectiveness of four tobacco control interventions: Tobacco taxation, mass media campaigns, school programs, and cessation support, and to illustrate how available evaluation tools can be adapted to the local setting.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Aims and Methods<\/jats:title>\n                  <jats:p>We used the dynamic population health modeling-health impact assessment tool to project the future smoking prevalence associated with the interventions and to simulate the resulting smoking-related disease burden over time. Applying the most recent available national Mongolian data as input, the costs and effects of four interventions were compared to a business-as-usual scenario, resulting in costs per life year gained and per disability-adjusted life years (DALYs) averted.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Three years after implementation, all interventions reduce the prevalence of current smoking, with the strongest reduction observed with the increase in tobacco tax (5.1% points), followed by mass media campaigns (1.6% points), school programs (1.3% points), and cessation support interventions (0.6% points). School programs were a cost-saving tobacco control intervention compared to current practice in Mongolia, while the other programs resulted in additional costs compared to business as usual. Compared to the World Health Organization (WHO) thresholds, all interventions would be considered \u201cvery cost-effective\u201d in terms of cost per DALY averted (below US$ 4295 per DALY averted) in Mongolia.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Large-scale interventions such as taxation and mass media campaigns result in both cost-effectiveness and important health benefits in relation to intervention costs. Reducing the prevalence of smoking among the male population would be particularly worthwhile in Mongolia.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Implications<\/jats:title>\n                  <jats:p>This study shows that in Mongolia school programs were a cost-saving intervention, while the cost-effectiveness ratios were US$ 25 per disability-adjusted life year (DALY) averted for mass media campaigns, US$ 74 for taxation, and US$ 1961 for cessation support interventions. Compared to the WHO thresholds, all interventions would be considered \u201cvery cost-effective\u201d in terms of expenses per DALY averted (&amp;lt;US$ 4295 per DALY averted), making it beneficial to scale up the WHO-Monitor tobacco use and prevention, Protect people from smoke, Offer help to quit smoking, Warn about the danger, Enforce bans, and Raise taxes (MPOWER) interventions to reduce the burden from smoking in Mongolia.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ntr\/ntad111","type":"journal-article","created":{"date-parts":[[2023,7,21]],"date-time":"2023-07-21T21:34:32Z","timestamp":1689975272000},"page":"1719-1726","source":"Crossref","is-referenced-by-count":1,"title":["Cost-Effectiveness of Four Tobacco Control Interventions in Mongolia"],"prefix":"10.1093","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3847-6974","authenticated-orcid":false,"given":"Ariuntuya","family":"Tuvdendorj","sequence":"first","affiliation":[{"name":"Department of Health Policy, School of Public Health, Mongolian National University of Medical Sciences , Ulaanbaatar , Mongolia"},{"name":"Department of Epidemiology, University Medical Center Groningen, University of Groningen , Groningen , The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Talitha","family":"Feenstra","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, University Medical Center Groningen, University of Groningen , Groningen , The Netherlands"},{"name":"Faculty of Science and Engineering, Groningen Research Institute of Pharmacy, University of Groningen , Groningen , The Netherlands"},{"name":"Faculty of Science and Engineering, Centre for Nutrition, Prevention, and Health Services, Institute for Public Health and the Environment , Bilthoven , The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erik","family":"Buskens","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, University Medical Center Groningen, University of Groningen , Groningen , The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2023,7,21]]},"reference":[{"issue":"3","key":"2023090404200449700_CIT0001","first-page":"581","article-title":"The MPOWER package","volume":"34","author":"WHO report on the global tobacco epidemic","year":"2008","journal-title":"Popul Dev Rev"},{"issue":"9972","key":"2023090404200449700_CIT0002","doi-asserted-by":"crossref","first-page":"1011","DOI":"10.1016\/S0140-6736(15)60133-7","article-title":"Tobacco-free world 1 A tobacco-free world: a call to action to phase out the sale of tobacco products by 2040","volume":"385","author":"Beaglehole","year":"2015","journal-title":"Lancet."},{"year":"2013","key":"2023090404200449700_CIT0003"},{"issue":"1","key":"2023090404200449700_CIT0004","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1186\/1478-7547-1-8","article-title":"Generalized 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