BACKGROUNDTobacco smoking is the cause of many preventable diseases and premature deaths in the UK and around the world. It poses enormous health- and non-health-related costs to the affected individuals, employers, and the society at large. The World Health Organization (WHO) estimates that, globally, smoking causes over US$500 billion in economic damage each year.OBJECTIVESThis paper examines global and UK evidence on the economic impact of smoking prevalence and evaluates the effectiveness and cost effectiveness of smoking cessation measures.STUDY SELECTIONSearch methodsWe used two major health care/economic research databases, namely PubMed and the National Institute for Health Research (NIHR) database that contains the British National Health Service (NHS) Economic Evaluation Database; Cochrane Library of systematic reviews in health care and health policy; and other health-care-related bibliographic sources. We also performed hand searching of relevant articles, health reports, and white papers issued by government bodies, international health organizations, and health intervention campaign agencies.Selection criteriaThe paper includes cost-effectiveness studies from medical journals, health reports, and white papers published between 1992 and July 2014, but included only eight relevant studies before 1992. Most of the papers reviewed reported outcomes on smoking prevalence, as well as the direct and indirect costs of smoking and the costs and benefits of smoking cessation interventions. We excluded papers that merely described the effectiveness of an intervention without including economic or cost considerations. We also excluded papers that combine smoking cessation with the reduction in the risk of other diseases.Data collection and analysisThe included studies were assessed against criteria indicated in the Cochrane Reviewers Handbook version 5.0.0.Outcomes assessed in the reviewPrimary outcomes of the selected studies are smoking prevalence, direct and indirect costs of smoking, and the costs and benefits of smoking cessation interventions (eg, “cost per quitter”, “cost per life year saved”, “cost per quality-adjusted life year gained,” “present value” or “net benefits” from smoking cessation, and “cost savings” from personal health care expenditure).MAIN RESULTSThe main findings of this study are as follows: The costs of smoking can be classified into direct, indirect, and intangible costs. About 15% of the aggregate health care expenditure in high-income countries can be attributed to smoking. In the US, the proportion of health care expenditure attributable to smoking ranges between 6% and 18% across different states. In the UK, the direct costs of smoking to the NHS have been estimated at between £2.7 billion and £5.2 billion, which is equivalent to around 5% of the total NHS budget each year. The economic burden of smoking estimated in terms of GDP reveals that smoking accounts for approximately 0.7% of China’s GDP and approximately 1% of US GDP. As part of the indirect (non-health-related) costs ...
In a policy arena in which the interest groups and stakeholders have different perceptions of appropriate policy responses to alcohol-related harm, a robust methodology to assess the impact of policy will contribute to the debate.
In the complex context of green consumption, researchers have examined the impact of many variables on pro-environmental behaviours, but have paid little attention to the effects of specific combinations of factors. This study fills this gap, using innovative methods to show how a combination of demographic variables, values, normative influence, personality traits and beliefs can stimulate travellers' willingness to pay more (WLP), using one qualitative and two quantitative studies. In a strong methodological contribution, we develop a model based on complexity theory, which was validated using fuzzy-set qualitative comparative analysis (fsQCA) of 642 travellers. The results indicate that our integrated model has a favourable level of predictive power for travellers' behaviour. Our findings suggest that no single factor is sufficient to drive travellers' willingness to pay more, but the results of the fsQCA in four configurations propose eight causal recipes for achieving high WLP. Alongside its significant methodological contribution, our study makes strong theoretical and practical contributions, including how managers can target their green travel products more effectively.
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