title: Cost effectiveness of tobacco control policies in Vietnam: the case of population-level interventions.
abstract: BACKGROUND
  Tobacco smoking is one of the leading public health problems in the world. It is also possible to prevent and/or reduce the harm from tobacco use through the use of cost-effective tobacco control measures. However, most of this evidence comes from developed countries and little research has been conducted on this issue in developing countries.
  
  
  OBJECTIVE
  The objective of this study was to analyse the cost effectiveness of four population-level tobacco control interventions in Vietnam.
  
  
  METHODS
  Four tobacco control interventions were evaluated: excise tax increase; graphic warning labels on cigarette packs; mass media campaigns; and smoking bans (in public or in work places). A multi-state life table model was constructed in Microsoft® Excel to examine the cost effectiveness of the tobacco control intervention options. A government perspective was adopted, with costing conducted using a bottom-up approach. Health improvement was considered in terms of disability-adjusted life-years (DALYs) averted. All assumptions were subject to sensitivity and uncertainty analysis.
  
  
  RESULTS
  All the interventions fell within the definition of being very cost effective according to the threshold level suggested by the WHO (i.e. <GDP per capita). Graphic warning labels on cigarette packs was the most cost-effective option, followed by excise tax increases, mass media campaigns, public smoking bans and work place smoking bans. If the cost offset was included in the analysis, all interventions would provide cost savings to the government health sector.
  
  
  CONCLUSIONS
  All four interventions to reduce the harm from tobacco use appear to be highly cost effective and should be considered as priorities in the context of Vietnam. The government may initially consider graphic warning labels and tax increase, followed by other interventions.
authors.affiliation: School of Population Health, The University of Queensland, Brisbane, Queensland, Australia. h.higashi@uqconnect.edu.au
authors.forename: Hideki
authors.initials: H
authors.lastname: Higashi
authors.forename: Khoa D
authors.initials: KD
authors.lastname: Truong
authors.forename: Jan J
authors.initials: JJ
authors.lastname: Barendregt
authors.forename: Phuong K
authors.initials: PK
authors.lastname: Nguyen
authors.forename: Mai L
authors.initials: ML
authors.lastname: Vuong
authors.forename: Thuy T
authors.initials: TT
authors.lastname: Nguyen
authors.forename: Phuong T
authors.initials: PT
authors.lastname: Hoang
authors.forename: Angela L
authors.initials: AL
authors.lastname: Wallace
authors.forename: Tien V
authors.initials: TV
authors.lastname: Tran
authors.forename: Cuong Q
authors.initials: CQ
authors.lastname: Le
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Doran
mesh_terms: D000293:Adolescent; D000328:Adult; D003362:Cost-Benefit Analysis; D005260:Female; D006293:Health Promotion / Q000191:economics* / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015397:Program Evaluation / Q000191:economics* / Q000379:methods; D012907:Smoking / Q000191:economics; D000074606:Smoking Prevention; D014744:Vietnam; D055815:Young Adult