Search

Abstract: Background and aims: Modelling return on investment (ROI) from smoking cessation interventions requires estimates of their costs and benefits. This paper describes a standardized method developed to source both economic costs of tobacco smoking and costs of implementing cessation interventions for a Europe‐wide ROI model [European study on Quantifying Utility of Investment in Protection from Tobacco model (EQUIPTMOD)]. Design: Focused search of administrative and published data. A standardized checklist was developed in order to ensure consistency in methods of data collection. Setting and participants: Adult population (15+ years) in Hungary, Netherlands, Germany, Spain and England. For passive smoking‐related costs, child population (0–15 years) was also included. Measurements: Costs of treating smoking‐attributable diseases; productivity losses due to smoking‐attributable absenteeism; and costs of implementing smoking cessation interventions. Findings: Annual costs (per case) of treating smoking attributable lung cancer were between €5074 (Hungary) and €52 106 (Germany); coronary heart disease between €1521 (Spain) and €3955 (Netherlands); chronic obstructive pulmonary disease between €1280 (England) and €4199 (Spain); stroke between €1829 (Hungary) and €14 880 (Netherlands). Costs (per recipient) of smoking cessation medications were estimated to be: for standard duration of varenicline between €225 (England) and €465 (Hungary); for bupropion between €25 (Hungary) and €220 (Germany). Costs (per recipient) of providing behavioural support were also wide‐ranging: one‐to‐one behavioural support between €34 (Hungary) and €474 (Netherlands); and group‐based behavioural support between €12 (Hungary) and €257 (Germany). The costs (per recipient) of delivering brief physician advice were: €24 (England); €9 (Germany); €4 (Hungary); €33 (Netherlands); and €27 (Spain). Conclusions: Costs of treating smoking‐attributable diseases as well as the costs of implementing smoking cessation interventions vary substantially across Hungary, Netherlands, Germany, Spain and England. Estimates for the costs of these diseases and interventions can contribute to return on investment estimates in support of national or regional policy decisions. [ABSTRACT FROM AUTHOR]

Aims To provide an overview of the gambling landscape and gambling-related problems in France, including the history, legislation, gambling policy and epidemiological data on excessive gambling. Method A literature review, using Medline, PsycInfo and Toxibase/OFDT databases, based on the systematic monitoring of scientific literature since 2008 (including French and international papers). Results Since 1776 and the creation of the royal lottery, state monopoly has been the main pillar of gambling policy in France. Increases in gambling venues and opportunities, growing evidence of gambling-related problems, pressures from the European Commission and the growth of on-line gambling have led to major changes in this policy: while land-based gambling remains mainly in the form of a state monopoly, on-line gambling was partially liberalized in 2010, and regulation authorities were established. The first epidemiological survey was conducted in 2010. Rates of problematic gambling in France are within the average of other European countries. Treatment has begun to be made available within addiction centres. Conclusion A majority of on-line gamblers in France use legal websites, which was one of the initial goals of liberalization. Recent studies confirm that the prevalence of problem gambling in France is far higher among on-line gamblers than among land-based gamblers; however, this difference cannot be attributed only to greater addictiveness of on-line gambling. [ABSTRACT FROM AUTHOR]

Alcohol is a major risk factor for burden of disease and injury in Europe, and contributes markedly to between region differences in life expectancy. Monitoring and surveillance systems have shown to be a key factor in implementing effective policies. The aim of this paper is to propose a system of indicators for alcohol consumption and attributable harm which can be used as an over-time monitoring tool at the country level as well as for comparisons between countries. A systematic research in electronic data bases was conducted but most of the information was derived from ongoing international efforts to establish alcohol monitoring and surveillance systems. European Union. Countries. Exposure to alcohol, mortality, burden of disease. Adult per capita alcohol consumption, prevalence of abstention, and frequency of drinking more than 60g pure alcohol in one occasion are proposed as a minimal set of alcohol exposure indicators, which can quickly be implemented in all EU countries. With respect to health harm indicators, the best minimal choice which can be implemented quickly in all countries of the EU would be alcohol-attributable years of life lost due to premature death. In addition, country specific indicators could be added, when alcohol places specific burden on specific diseases. National and European Union-wide monitoring systems for alcohol exposure and attributable harm to inform public health-related policy decisions could be implemented easily. The establishement of such monitoring systems would follow the recent World Assembly resolution for a global strategy to reduce alcohol-related harm. [ABSTRACT FROM AUTHOR]