Study shows smoking prevention school programs in India are cost-effective

In a milestone study carried in India to economically analyze tobacco prevention school programs, it is found that such programs provide large benefits, in terms of health, per rupee invested in comparison to alternative investments in health. This cost effectiveness analysis makes the case for upscaling such interventions in Indian schools by policymakers in the health and education field.

New Delhi, Delhi, March 13, 2012 /India PRwire/ -- Public health researchers from India and US have found in a recent study that school-based smoking prevention programs in India are cost-effective, thus strengthening a case for introducing tobacco control as a school program across the country. In a milestone study carried in India to economically analyze tobacco prevention school programs, it is found that such programs provide large benefits, in terms of health, per rupee invested in comparison to alternative investments in health. This cost effectiveness analysis makes the case for upscaling such interventions in Indian schools by policymakers in the health and education field.

The study titled 'The Cost-effectiveness of a school-based smoking prevention program in India' has been published in Health Promotion International Advance Access (doi:10:1093/heapro/dar095). The cost effectiveness analysis is based on Project MYTRI (Mobilizing Youth for Tobacco-Related Initiatives) which was implemented in 32 schools of Delhi and Chennai during the period 2004-2006, in which 14000 students between ages 14-16 years of grades 6-9 participated. The program was implemented jointly by a Delhi-based NGO HRIDAY, in collaboration with the University of Texas, School of Public Health, USA.

The study projected that Project MYTRI resulted in nearly 12 people averting tobacco use by the age of 26 years translating to 2.88 life-years added per averted tobacco user. A detailed analysis stated that an improved quality-adjusted life-year under our program costs only 1.25 lakh rupee ($2769), which is far less than what a quality-adjusted life-year costs under traditional medical procedures like surgery. This emphasizes the necessity for introducing multi-component interventions like MYTRI.

"The study reveals that the cost per life year added due to averted smoking was nearly 1.8 lakh rupees ($4348). So if the project has been able to add 54 life years, it would cost about 1 crore rupees ($234792), which is a bargain in comparison to alternative investments in health, such as end of life surgery" highlights Prof. Shelton Brown, Associate Professor of Health Economics at the School of Public Health, University of Texas and the lead investigator of the study.

"The evidence from this study has further bolstered the focus on youth interventions in the project STEPS - a multi-component comprehensive tobacco control programme in the states of Andhra Pradesh and Gujarat. It has propelled the scientific discussion and further underscored the need to expand such interventions to larger scale and thus this school based tobacco prevention programme is being replicated in 960 primary and secondary schools in these two states through appropriate cultural adaptation", adds Dr. Monika Arora, Head: Health Promotion and Tobacco Control, Public Health Foundation of India, who is also Senior Director at HRIDAY.

In India, high prevalence of tobacco consumption is one of the major challenges to health and wellbeing of its citizens. About 2700 Indians die every day from tobacco use. Research shows that 5500 youth in India start using tobacco daily. A survey of tobacco use among young people, the Global Youth Tobacco Survey-2009, reveals that nearly 15% of youth currently use tobacco in India.

MYTRI study had shown that current tobacco use decreased by 17% in the intervention group and increased by 68% in the control group over the project duration of two years from 2004 to 2006.

Notes to Editor

A cost-effectiveness analysis takes the impact of a program (e.g. percent reductions in the incidence of a disease say, diarrhea/cancer), and divides that by the cost of the program, generating a statistic such as: the number of cases of diarrhea/cancer prevented per unit of money spent. This makes no judgment of the value of reducing the disease.

A quality-adjusted life-year (QALY) takes into account both the quantity and quality of life generated by healthcare interventions. It is the arithmetic product of life expectancy and a measure of the quality of the remaining life-years.


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