The cost-effectiveness of raising the legal smoking age in California
The cost-effectiveness of raising the legal smoking age in California
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DOI：
10.1177/0272989x05276859
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发表时间：
2005-06-01
影响因子：
3.6
通讯作者：
Ahmad, S
中科院分区：
文献类型：
--
作者：
Ahmad, S
有证据表明，大多数吸烟者在18岁之前开始吸烟，而在生命早期开始吸烟的吸烟者戒烟的可能性较小，因此，减少或推迟开始吸烟的政策可能会对公共卫生产生重大影响。将法定最低购买年龄提高到21岁，对各州来说可能是减少青少年吸烟的有效方法，因为这会使青少年更难从商店购买香烟，并减少他们在正常社交圈中遇到的合法购买者的数量。为了了解加州正在进行的关于这一政策选择的辩论，本研究对将该州的法定吸烟年龄提高到21岁的成本效益进行了评估。使用动态计算机模拟模型从社会角度估算成本和收益，该模型模拟加州人口年龄、组成和吸烟行为随时间的变化。模型参数的辅助数据是从公开来源获得的。根据50年期间加州人口的吸烟率和累积质量调整生命年（QALYs）的变化，估计了人口健康影响。经济影响以节省的医疗费用、执法费用和检查身份的费用为货币来衡量。与现状模拟相比，将吸烟年龄提高到21岁将导致青少年（14-17岁）吸烟率从13.3%下降到2.4%（减少82%）。这项政策不会产生任何净成本，事实上，在未来50年里，它将为该州及其居民节省240亿美元，与目前相比，它将增加147万个质量年。这项研究应该对加州的政策制定者有用，因为他们正在考虑立法提高该州的法定吸烟年龄。
Given evidence that most smokers start smoking before the age of 18 and that smokers who start earlier in life are less likely to quit, policies that reduce or delay initiation could have a large impact on public health. Raising the legal minimum purchase age of cigarettes to 21 may be an effective way for states to reduce youth smoking by making it harder for teens to buy cigarettes from stores and by reducing the number of legal buyers they encounter in their normal social circles. To inform the ongoing debate over this policy option in California, this study provides an evaluation of the cost-effectiveness of raising the state's legal smoking age to 21. Costs and benefits were estimated from a societal perspective using a dynamic computer simulation model that simulates changes to the California population in age, composition, and smoking behavior over time. Secondary data for model parameters were obtained from publicly available sources. Population health impacts were estimated in terms of smoking prevalence and the change in cumulative quality-adjusted life years (QALYs) to the California population over a 50-year period. Economic impacts were measured in monetary terms for medical cost savings, cost of law enforcement, and cost of checking identification. Compared to a status quo simulation, raising the smoking age to 21 would result in a drop in teen (ages 14-17) smoking prevalence from 13.3% to 2.4% (82% reduction). The policy would generate no net costs, in fact saving the state and its inhabitants a total of $24 billion over the next 50 years with a gain of 1.47 million QALYs compared to status quo. This research should prove useful to California's policy makers as they contemplate legislation to raise the state's legal smoking age.