The cost-effectiveness of a school-based smoking prevention program in India

Health Promot Int. 2013 Jun;28(2):178-86. doi: 10.1093/heapro/dar095. Epub 2012 Jan 23.


Intervention programs aimed at preventing tobacco use among youth have been shown to be effective in curbing tobacco use onset and progression. However, the effects of even very successful tobacco prevention programs may not always impress policy-makers and lay audiences. Economic analysis potentially strengthens the case. In this paper, we evaluate the cost-effectiveness of a youth tobacco use prevention program which has been translated and implemented in India, a developing country. Although programs like these are inexpensive to implement in the USA, they are even less expensive in India due to low labor costs. Our results show that the costs per quality-adjusted life-year added, due to averted smoking, was $2057, even without including averted medical costs. If we ignore student time, cost-effectiveness improves by roughly 10%. To put the cost-effectiveness of this smoking prevention program into context, it is over 24 times more cost-effective than dialysis in the USA, which costs $50,000 for a life-year.

Keywords: cost-effectiveness; developing country; smoking prevention; tobacco.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Child
  • Cost-Benefit Analysis
  • Female
  • Health Care Costs
  • Humans
  • India
  • Male
  • Models, Economic
  • Quality-Adjusted Life Years
  • School Health Services / economics*
  • School Health Services / organization & administration
  • Smoking / economics
  • Smoking Prevention*