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Future Health and Economic Impact of Comprehensive Tobacco Control in DoD: A Microsimulation Approach
Wenya Yang1, Quan Zou1, Eleonora Tan1
1The Lewin Group, 3130 Fairview Park Dr., Suite 500, Falls Church, VA 22042.
Military Medicine
|February 6, 2018
Summary
Implementing comprehensive tobacco control initiatives in the military can significantly reduce smoking prevalence and save billions in lifetime medical costs. A multi-faceted approach can lead to substantial health and economic benefits for the Department of Defense (DoD) and its beneficiaries.
Area of Science:
- Public Health
- Health Economics
- Military Health System
Background:
- Tobacco use is a significant concern within the Military Health System, with higher smoking rates among active duty personnel compared to the civilian population.
- Tobacco use incurs substantial annual costs for the Department of Defense (DoD) due to medical care, hospitalizations, and lost workdays.
Purpose of the Study:
- To evaluate the future health outcomes and economic impact of tobacco control initiatives for Tricare Prime beneficiaries.
- To model the potential savings associated with transforming the military into a tobacco-free environment.
Main Methods:
- A Markov Chain Monte Carlo microsimulation model was used to simulate smoking status, disease risk, and medical costs for 3.2 million Tricare Prime beneficiaries.
- Data from Tricare administrative records, CDC mortality data, NCI cancer registry data, and literature reviews were utilized.
Main Results:
- A comprehensive tobacco control initiative could decrease smoking prevalence from 24% to 16% by 2020, resulting in an estimated $968 million in lifetime medical cost savings.
- Achieving the Healthy People 2020 goal of 12% smoking prevalence could lead to $2.08 billion in lifetime savings.
Conclusions:
- Comprehensive tobacco control policies can significantly reduce tobacco use prevalence and associated lifetime medical costs within the DoD.
- Effective program design and implementation are crucial for realizing future savings and achieving a tobacco-free military environment.
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