Future burden and costs of smoking-related disease in the Netherlands: a dynamic modeling approach.
OBJECTIVE
In this article, we explore the future health gain of different policy measures to reduce smoking prevalence: health education campaigns specifically aimed at keeping (young) people from starting to smoke, campaigns aimed at persuading smokers to quit, and tax measures.


METHODS
We drew up different policy scenarios based on evaluations of several health promotion campaigns. Implementing these into the dynamic multistate models, we simulated smoking prevalence, loss of life-years, and costs for several decades into the next century.


RESULTS
In the short run, campaigns aimed at potential "quitters" appear to be most effective in terms of health gain. However, their effect fades away after several decades, while campaigns aimed at young "starters" or tax measures in the end yield a larger and more lasting decrease in smoking attributable disease burden.


CONCLUSIONS
Dynamic modeling is very useful tool in calculating costs and effects of preventive public health measures.
van Genugten
Marianne L L
ML
National Institute of Public Health and the Environment, Bilthoven, the Netherlands. marianne.van.genugten@rivm.nl
Hoogenveen
Rudolf T
RT
Mulder
Ina
I
Smit
Henriëtte A
HA
Jansen
Jan
J
de Hollander
Augustinus E M
AE
D000328:Adult; D000368:Aged; D002648:Child; D017281:Cost of Illness; D006233:Persons with Disabilities; D005260:Female; D006291:Health Policy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D015995:Prevalence; D011634:Public Health; D019057:Quality-Adjusted Life Years; D012907:Smoking / Q000009:adverse effects* / Q000191:economics / Q000453:epidemiology*