Tobacco Endgame Simulation Modelling: Assessing the Impact of Policy Changes on Smoking Prevalence in 2035

Michael Chaiton,Robert Schwartz,Jolene Dubray,G Emmanuel Guindon

doi:10.3390/forecast3020017

Abstract

Smoking causes substantial amount of mortality and morbidity. This article presents the findings from simulation models that projected the impact of five potential Tobacco Endgame strategies on smoking prevalence in Ontario by 2035 and expected impact of smoking prevalence “less than 5 by 35” on tax revenue. We used Ontario SimSmoke simulation for modelling the expected impact of four strategies: plain packaging, free cessation services, decreasing the number of tobacco outlets, and increasing tobacco taxes. Separate models were used to project the impact of increasing the minimum age to legally purchase tobacco to 21 years on smoking prevalence and impact of price and tax increase to achieve “less than 5 by 35” on taxation revenue. The combined effect of four strategies in Ontario SimSmoke Model are expected to reduce smoking prevalence by 8.5% in 2035. Increasing tobacco taxes had the greatest independent predicted decrease in smoking prevalence (2.8%) followed by raised minimum age for legal purchase to 21 years (2.4%), decreasing tobacco outlets (1.5%), free cessation services (0.7%), and plain packaging (0.6%). Increasing tobacco excise tax and prices are projected to have minimal impact on taxation revenue, with a decrease from 1.5 billion to 1.2 billion annual tax receipts.

Highlights

Great strides have been made in tobacco control in Canada and globally over the past few decades through implementation of various measures, including those endorsed by the international Framework Convention for Tobacco Control [FCTC] [1]
We describe the findings from simulation models that assessed the impact in Ontario of five potential Tobacco Endgame strategies [4]
The purpose of this paper is to evaluate the expected impact of endgame policies and understand the expected tax revenue impact of reducing smoking prevalence to less than 5%

Summary

Introduction

Great strides have been made in tobacco control in Canada and globally over the past few decades through implementation of various measures, including those endorsed by the international Framework Convention for Tobacco Control [FCTC] [1]. Canadians lose an estimated 515,607 person years of life every year as a result of premature mortality from tobacco smoking [3]. The idea of a “Tobacco Endgame” is based on the perspective that “control” of tobacco will never be enough to deal with the epidemic of tobacco related diseases and that the focus must be shifted to develop strategies to reach a future that is free of commercial tobacco. This notion of “endgame” is qualitatively different from tobacco control strategies currently in place. This recognition is becoming more widespread and is increasingly leading to the view that a strategy for an “endgame” for commercial tobacco is required

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