Cost effectiveness of tobacco control policies in Vietnam: the case of population-level interventions.

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.