Journal Information
Vol. 16. Issue 4.
Pages 308-317 (July - August 2002)
Vol. 16. Issue 4.
Pages 308-317 (July - August 2002)
Open Access
Morbilidad, mortalidad y costes sanitarios evitables mediante una estrategia de tratamiento del tabaquismo en España
(The effects of implementing a smoking cessation intervention in Spain on morbidity, mortality and health care costs)
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J. González-Enríqueza,
Corresponding author
jgonza@isciii.es

Correspondencia: Jesús González-Enríquez. Agencia de Evaluación de Tecnologías Sanitarias. Instituto de Salud Carlos III. Sinesio Delgado, s/n. 28029 Madrid.
, T. Salvador-Llivinab, A. López-Nicolásc, E. Antón de las Herasd, A. Musind, E. Fernándeze, M. Garcíae, A. Schiaffinoe, I. Pérez-Escolanod
a Agencia de Evaluación de Tecnologías Sanitarias. Instituto de Salud Carlos III. Madrid
b Centro de Estudios sobre Promoción de la Salud
c Universidad Pompeu Fabra. Departament d'Economia i Empresa. Centre de Recerca en Economia i Salut. Barcelona
d Health Outcomes HO. GlaxoSmithKline
e Institut Català d'Oncologia. Servei de Prevenció i Control del Cáncer. Barcelona
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Resumen
Objetivo

Se valoran los efectos que tendría una intervención destinada a reducir el uso de tabaco en la población española de fumadores sobre la morbilidad, la mortalidad y los costes asociados al consumo de tabaco.

Método

Se ha adaptado el modelo Health and Economic Consequences of Smoking patrocinado por la OMS y desarrollado por The Lewin Group. La intervención propuesta incluye el acceso a asistencia farmacológica de un 35% de los fumadores que intentan dejar de fumar, y obtienen una tasa global de cesación al año del 7,2%. Las enfermedades estudiadas son: cáncer de pulmón, enfermedad coronaria, enfermedad cerebrovascular, EPOC, asma y bajo peso al nacer. Se estiman los casos de enfermedad y muerte atribuibles al consumo de tabaco evitados y la reducción en el coste sanitario debidos a la intervención, proyectados a 20 años.

Resultados

Sin intervención, en el año 1 del modelo 2.136.094 fumadores padecen alguna de las condiciones clínicas atribuibles al consumo de tabaco, el coste asistencial es de 4.286 millones de euros y las muertes atribuibles son 26.537. La intervención propuesta evita 2.613, 9.192, 17.415 y 23.837 casos de enfermedad atribuible al consumo de tabaco en los años 2, 5, 10 y 20 del modelo, respectivamente. Los costes asistenciales acumulados evitados son 3,5 millones de euros en el año 2 y 386 millones de euros a los 20 años. Las muertes acumuladas evitadas son 284 en el año 2 y 9.205 a los 20 años de la intervención. La intervención añade un total de 78.173 años de vida al final del período considerado.

Conclusiones

La disponibilidad de nuevas intervenciones eficaces en el tratamiento del tabaquismo y el incremento de la accesibilidad a las mismas pueden contribuir de forma relevante a la reducción de la morbilidad, la mortalidad y los costes sanitarios asociados al tabaquismo en España.

Palabras clave:
Tabaco
Tabaquismo
Mortalidad
Política asistencial
Prevención y control
Modelo económico
Abstract
Objective

We estimated the effect that a smoking cessation intervention in the Spanish population of smokers would have on smoking-related morbidity, mortality and healthcare costs.

Methods

We adopted the model Health and Economic Consequences of Smoking sponsored by the WHO Health Organization and developed by the The Lewin Group. The smoking cessation intervention proposed incluides pharmacological treatment to 35% of smokers who are trying to quit smoking and obtains a quit rate of 7.2%. The diseases studied are: lung cancer, heart disease, stroke, chronic obstructive pulmonary disease, asthma exacerbation, and low birth weight. The smoking- related cases of disease and of averted death and the reduction in healthcare expenditure due to the intervention were estimated.

Results

Without intervention, at year 1 of the model, 2,136,094 smokers would be affected by some smoking-related disease; healthcare expenditure would be 4,286 million e and deaths attributable to smoking would total 26,537. The proposed intervention would prevent 2,613, 9,192, 17,415 and 23,837 cases of smoking-related disease at years 2, 5, 10 and 20 of the model, respectively. The saving in accumulated healthcare costs would amount to 3.5 million e at year 2 and 386 million e over 20 years. The accumulated prevented deaths are 284 at year 2 and 9,205 over 20 years. The intervention would save a total of 78,173 life-years by the end of the period considered.

Conclusions

The availability of new effective smoking cessation interventions and the increase in accessibility to such interventions may contribute significantly to reducing morbidity, mortality and healthcare costs associated with smoking in Spain.

Key words:
Smoking
Smoking cessation policy
Mortality
Prevention and control
Economic model
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