Potential population impact of changes in heroin treatment and smoking prevalence rates: using Population Impact Measures.
BACKGROUND
The drug misuse and asthma are major health problems in urban settings. There are effective interventions to reduce cigarette smoking and also to treat heroin use; in the context of European System of Urban Health Indicators Project (EURO-URHIS), we explored the use of Population Impact Measures (PIMs) to describe the potential for increase in methadone use and reduction in cigarette smoking to reduce deaths -from heroin use- and asthma events in examples of urban populations.


METHODS
The two PIMs calculated here are the Number of Events Prevented in your Population (NEPP) and the Population Impact Number of Eliminating (or reducing the prevalence of) a Risk Factor (PIN-ER-t).


RESULTS
Increasing methadone treatment uptake from its current levels to 90% would prevent 21 (95% CI: 11-34) deaths in Manchester City, 218 (95% CI: 114-339) in Greater London and overall 1 243 (95% CI: 641-1953) in England in 1 year. In males 2 (95% CI: -22 to 28), 27 (95% CI: -296 to 363) and 170 (95% CI: -1757 to 2186) and in females 36 (95% CI: 6-70), 0 and 2312 (95% CI: 934-3783) fewer asthma cases per year would have been expected in Manchester City, Greater London and overall in England respectively, if the smoking prevalence is reduced from current levels to 20% in both sexes.


CONCLUSIONS
PIMs provide estimates of absolute risk and benefit to a total population, of potential use to policy-makers since current practice and intervention goals are taken into account.
Torun
Perihan
P
Clinical Epidemiology and Public Health Unit, Stopford Building University of Manchester, Manchester, UK. perihan.torun@manchester.ac.uk
Heller
Richard F
RF
Verma
Arpana
A
D000293:Adolescent; D000328:Adult; D001249:Asthma / Q000453:epidemiology; D004739:England / Q000453:epidemiology; D005260:Female; D006305:Health Status Indicators; D006556:Heroin Dependence / Q000188:drug therapy* / Q000401:mortality; D006801:Humans; D008297:Male; D008691:Methadone / Q000008:administration & dosage / Q000627:therapeutic use; D008875:Middle Aged; D011159:Population Surveillance; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology*; D055815:Young Adult
D008691:Methadone