The case for investment in tobacco control: lessons from four countries in the Americas

Author:

Hutchinson Brian12,Brispat Farisha3,Calderón Pinzón Lorena Viviana4,Sarmiento Alejandra5,Solís Esteban6,Nugent Rachel1,Mann Nathan1,Spencer Garrison1,Ngongo Carrie1,Black Andrew7,Audera-Lopez Maria Carmen7,Ntiabang Tih Armstrong7,Tarlton Dudley8,Cooke Juana9,Small Roy10,Roche Maxime11,Sandoval Rosa Carolina11

Affiliation:

1. RTI International, Seattle, United States of America.

2. bhutchinson@rti.org

3. Ministry of Health, Paramaribo, Suriname

4. Ministry of Health and Social Protection, Bogotá, Colombia

5. Fondo Solidario para la Salud (Fosalud), San Salvador, El Salvador

6. Ministry of Health, San José, Costa Rica

7. WHO FCTC Secretariat, Geneva, Switzerland

8. United Nations Development Programme, Istanbul, Turkey

9. United Nations Development Programme, Panama City, Panama

10. United Nations Development Programme, New York City, United States of America

11. Pan American Health Organization, Washington DC, United States of America

Abstract

Objective.

To synthesize learnings from four national tobacco control investment cases conducted in the Americas (Colombia, Costa Rica, El Salvador, Suriname) under the World Health Organization Framework Convention on Tobacco Control (WHO FCTC) 2030 project, to describe results and how national health authorities have used the cases, and to discuss implications for the role of investment cases in advancing tobacco control.

Methods.

We draw on findings from four national investment cases that included 1) a cost-of-illness analysis calculating the health and economic burden of tobacco use, 2) a return-on-investment analysis of implementing key tobacco control demand reduction measures, and 3) a subsidiary analysis of one tobacco control topic of national interest (e.g., equity implications of cigarette taxation). Co-authors reported how cases have been used to advance tobacco control.

Results.

In Colombia, Costa Rica, El Salvador, and Suriname, tobacco use causes social and economic losses equivalent to between 1.0 to 1.8 percent of GDP. Across these countries, implementing WHO FCTC demand reduction measures would save an average of 11 400 lives per year over the next 15 years. Benefits of the measures would far outweigh the costs of implementation and enforcement. Governments are using the cases to advance tobacco control, including to improve tobacco control laws and their enforcement, strengthen tobacco taxation, prioritize tobacco control planning, coordinate a multisectoral response, and engage political leaders.

Conclusions.

National investment cases can help to strengthen tobacco control in countries, including by increasing public and political support for implementation of the WHO FCTC and by informing effective planning, legislation, coordination and financing.

Publisher

Pan American Health Organization

Subject

Public Health, Environmental and Occupational Health

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