Even a partial cessation of smoking with the transition of conventional cigarettes to alternative smokeless systems can significantly reduce the costs of the health system. As a result, the total increase in GDP due to savings due to reduced morbidity, reduced disability and increased life expectancy may amount to 1.5 trillion rubles per year. Larisa Popovich, one of the authors of the study and director of the Institute of Health Economics at the National Research University Higher School of Economics, told RG about this.
At the same time, complete smoking cessation will bring even greater benefits to the budget, not to mention human lives. The predictive model of researchers from the Higher School of Economics (HSE) has been published in the journal Qualitative Clinical Practice.
A long-term household survey, which has been conducted by the HSE for many years, has shown that over the past ten years, the proportion of smokers in Russia has decreased by almost a quarter: from 31% in 2012 to 23% in 2022. However, now the situation has stagnated - the most avid smokers remain in the ranks, usually with long-term experience, who are not ready or unable to quit smoking. According to opinion polls, about a third of those who smoke say this.
Meanwhile, cigarettes shorten life by an average of 10-12 years. Therefore, the possibility of reducing the harm caused by tobacco smoking is becoming one of the main tasks of public health.
Along the way, scientists offer various options. HSE experts have calculated the economic benefits of a massive switch from heavy smokers to alternative nicotine delivery options. The analysis is based on data from reputable Cochrane Reviews (international systematic reviews of clinical trials, which are considered the gold standard of evidence-based medicine). The scientists also used the results of a 26-week clinical trial, which showed that when quitting cigarettes and replacing them with tobacco heating systems, the levels of biomarkers of harmful effects decrease by 16-49%. This data has become a key guideline for modeling.
Scientists used the DALY indicator, which shows how many years of life are lost due to illness, disability, or premature death. The fewer losses in this indicator, the better for society and the economy.
In the minimum scenario, where harm reduction is estimated most modestly at 16%, it was estimated that it would be possible to preserve about 632,000 years of healthy life in men (and at the most active age of 35-59 years) and prevent almost 19,000 premature deaths. For women, the effect is more modest, but still significant: about 396,000 years of life saved and over 2,000 lives saved.
In the second scenario, with a 49% reduction in harm, the results are doubled: men have up to 1.3 million years of healthy life and more than 39,000 deaths prevented, women have about 822,000 years of disease-free life and up to 3.8 thousand lives saved.
"From an economic point of view, the introduction of harm reduction measures is also justified.: This can lead to an increase in GDP of up to 1.5 trillion rubles per year - by reducing losses from premature mortality, disability and deterioration of public health, increasing the cost of treatment and rehabilitation," explains Larisa Popovich.
The authors note that most scientific research in the field of alternatives to traditional smoking, when a smoker stops inhaling smoke (since heating is used, not burning tobacco), relies on markers of health effects. Gorenje It will take decades to obtain a complete evidence base - the long-term effects have yet to be assessed. However, the data from toxicological analyses already show a reduction in risks compared to regular cigarette smoking.
Consumer behavior data should also be taken into account, the researchers say. According to FOM surveys, the share of consumers of alternative nicotine-containing products in Russia has already reached 15% among the smoking audience. Moreover, surveys say that if these products become unavailable (banned), only 13% of respondents would be willing to completely give up the bad habit, but most simply returned to more harmful conventional cigarettes.
Scientists emphasize that the main goal of reducing the harm from smoking should be to completely stop it. The social and economic benefits in this case will increase many times. That is why, when making legislative decisions, it is important to use the most flexible methods of influencing behavior, helping smokers first reduce the harm from cigarettes, and in the future completely get rid of nicotine addiction.
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