Restricting tobacco sales to pharmacies

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University of Otago researchers have modelled potential benefits if tobacco sales were restricted to pharmacies, alongside cessation advice, and say it could help accelerate progress towards New Zealand becoming smoke-free. Though the restriction to pharmacies has been mooted as a possible smoke-free policy, this study is the first time researchers have attempted to model what the effects would be.

Journal/conference: Tobacco Control

DOI: 10.1136/tobaccocontrol-2018-054600

Organisation/s: University of Otago

Funder: University of Otago

Media Release

From: The BMJ


Objective Restricting tobacco sales to pharmacies only, including the provision of cessation advice, has been suggested as a potential measure to hasten progress towards the tobacco endgame. We aimed to quantify the impacts of this hypothetical intervention package on
future smoking prevalence, population health and health system costs for a country with an endgame goal: New Zealand (NZ).

Methods We used two peer-reviewed simulation models: 1) a dynamic population forecasting model for smoking prevalence and 2) a closed cohort multi-state
life-table model for future health gains and costs by sex, age and ethnicity. Greater costs due to increased travel distances to purchase tobacco were treated as an increase in the price of tobacco. Annual cessation rates were multiplied with the effect size for brief opportunistic
cessation advice on sustained smoking abstinence.

Results The intervention package was associated with a reduction in future smoking prevalence, such that by 2025 prevalence was 17.3%/6.8% for Māori (Indigenous)/non-Māori compared to 20.5%/8.1% projected under no intervention. The measure was
furthermore estimated to accrue 41 700 discounted quality-adjusted life-years (QALYs) (95% uncertainty interval (UI): 33 500 to 51 600) over the remainder of the 2011 NZ population’s lives. Of these QALYs gained, 74% were due to the provision of cessation advice over and above the limiting of sales to pharmacies.

Conclusions This work provides modelling-level evidence that the package of restricting tobacco sales to only pharmacies combined with cessation advice in these settings can accelerate progress towards the tobacco endgame, and achieve large population health benefits and cost-savings.

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