{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T00:25:34Z","timestamp":1773793534591,"version":"3.50.1"},"reference-count":49,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2019,7,27]],"date-time":"2019-07-27T00:00:00Z","timestamp":1564185600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"SILNE-R project"},{"name":"European Union\u2019s Horizon 2020 research and innovation program","award":["635056"],"award-info":[{"award-number":["635056"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,6,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Economic evaluations of tobacco control policies targeting adolescents are scarce. Few take into account real-world, large-scale implementation costs; few compare cost-effectiveness of different policies across different countries. We assessed the cost-effectiveness of five tobacco control policies (nonschool bans, including bans on sales to minors, bans on smoking in public places, bans on advertising at points-of-sale, school smoke-free bans, and school education programs), implemented in 2016 in Finland, Ireland, the Netherlands, Belgium, Germany, Italy, and Portugal.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Cost-effectiveness estimates were calculated per country and per policy, from the State perspective. Costs were collected by combining quantitative questionnaires with semi-structured interviews on how policies were implemented in each setting, in real practice. Short-term effectiveness was based on the literature, and long-term effectiveness was modeled using the DYNAMO-HIA tool. Discount rates of 3.5% were used for costs and effectiveness. Sensitivity analyses considered 1%\u201350% short-term effectiveness estimates, highest cost estimates, and undiscounted effectiveness.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Findings<\/jats:title>\n                  <jats:p>Nonschool bans cost up to \u20ac253.23 per healthy life year, school smoking bans up to \u20ac91.87 per healthy life year, and school education programs up to \u20ac481.35 per healthy life year. Cost-effectiveness depended on the costs of implementation, short-term effectiveness, initial smoking rates, dimension of the target population, and weight of smoking in overall mortality and morbidity.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>All five policies were highly cost-effective in all countries according to the World Health Organization thresholds for public health interventions. Cost-effectiveness was preserved even when using the highest costs and most conservative effectiveness estimates.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Implications<\/jats:title>\n                  <jats:p>Economic evaluations using real-world data on tobacco control policies implemented at a large scale are scarce, especially considering nonschool bans targeting adolescents. We assessed the cost-effectiveness of five tobacco control policies implemented in 2016 in Finland, Ireland, the Netherlands, Belgium, Germany, Italy, and Portugal. This study shows that all five policies were highly cost-effective considering the World Health Organization threshold, even when considering the highest costs and most conservative effectiveness estimates.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ntr\/ntz124","type":"journal-article","created":{"date-parts":[[2019,7,27]],"date-time":"2019-07-27T07:00:14Z","timestamp":1564210814000},"page":"1202-1209","source":"Crossref","is-referenced-by-count":6,"title":["Economic Evaluation of Five Tobacco Control Policies Across Seven European Countries"],"prefix":"10.1093","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7364-0100","authenticated-orcid":false,"given":"Teresa","family":"Le\u00e3o","sequence":"first","affiliation":[{"name":"Escola Nacional de Sa\u00fade P\u00fablica, Universidade NOVA de Lisboa, Lisboa, Portugal"},{"name":"Centro de Investiga\u00e7\u00e3o em Sa\u00fade P\u00fablica, Lisboa, Portugal"},{"name":"Local Health Unit of Matosinhos, Matosinhos, Portugal"}]},{"given":"Julian","family":"Perelman","sequence":"first","affiliation":[{"name":"Escola Nacional de Sa\u00fade P\u00fablica, Universidade NOVA de Lisboa, Lisboa, Portugal"},{"name":"Centro de Investiga\u00e7\u00e3o em Sa\u00fade P\u00fablica, Lisboa, Portugal"}]},{"given":"Luke","family":"Clancy","sequence":"first","affiliation":[{"name":"TobaccoFree Research Institute Ireland, Dublin, Ireland"}]},{"given":"Martin","family":"Mlinari\u0107","sequence":"first","affiliation":[{"name":"Institute of Medical Sociology, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle, Germany"}]},{"given":"Jaana M","family":"Kinnunen","sequence":"first","affiliation":[{"name":"Unit of Health Sciences, Faculty of Social Sciences, Tampere University, Tampere, Finland"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1156-658X","authenticated-orcid":false,"given":"Paulien A W","family":"Nuyts","sequence":"first","affiliation":[{"name":"Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7269-3537","authenticated-orcid":false,"given":"Nora","family":"M\u00e9lard","sequence":"first","affiliation":[{"name":"Institute of Health and Society, Universit\u00e9 catholique de Louvain, Brussels, Belgium"}]},{"given":"Arja","family":"Rimpel\u00e4","sequence":"first","affiliation":[{"name":"Unit of Health Sciences, Faculty of Social Sciences, Tampere University, Tampere, Finland"},{"name":"Department of Adolescent Psychiatry, Tampere University Hospital, Tampere, Finland"}]},{"given":"Vincent","family":"Lorant","sequence":"first","affiliation":[{"name":"Institute of Health and Society, Universit\u00e9 catholique de Louvain, Brussels, Belgium"}]},{"given":"Anton E","family":"Kunst","sequence":"first","affiliation":[{"name":"Amsterdam UMC, University of Amsterdam, Amsterdam, The 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