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Value Health. 2003 Jul-Aug;6(4):494-9.

Future burden and costs of smoking-related disease in the Netherlands: a dynamic modeling approach.

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National Institute of Public Health and the Environment, Bilthoven, the Netherlands.



In this article, we explore the future health gain of different policy measures to reduce smoking prevalence: health education campaigns specifically aimed at keeping (young) people from starting to smoke, campaigns aimed at persuading smokers to quit, and tax measures.


We drew up different policy scenarios based on evaluations of several health promotion campaigns. Implementing these into the dynamic multistate models, we simulated smoking prevalence, loss of life-years, and costs for several decades into the next century.


In the short run, campaigns aimed at potential "quitters" appear to be most effective in terms of health gain. However, their effect fades away after several decades, while campaigns aimed at young "starters" or tax measures in the end yield a larger and more lasting decrease in smoking attributable disease burden.


Dynamic modeling is very useful tool in calculating costs and effects of preventive public health measures.

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