The benefits from complying with the framework convention on tobacco control: a SimSmoke analysis of 15 European nations

Health Policy Plan. 2014 Dec;29(8):1031-42. doi: 10.1093/heapol/czt085. Epub 2013 Nov 20.


Introduction: This article compares the predicted impact of tobacco tax increases alone and as part of a comprehensive tobacco control strategy on smoking prevalence and smoking-attributable deaths (SADs) across 15 European countries.

Methods: Country-specific population, smoking prevalence and policy data with modified parameter values have been applied to the previously validated SimSmoke model for 10 high-income and 5 middle-income European nations. The impact of past and potential future policies is modelled.

Results: Models generally validated well across the 15 countries, and showed the impact of past policies. Without stronger future policies, 44 million lives would be lost due to smoking across the 15 study countries between 2011 and 2040, but effective policies could avert 7.7 million of those premature deaths.

Conclusions: Results suggest that past policies have been effective in reducing smoking rates, but there is also a strong potential for future policies consistent with the Framework Convention on Tobacco Control. When specific taxes are increased to 70% of retail price, strong smoke-free air laws, youth access laws and marketing restrictions are enforced, stronger health warnings are implemented, and cessation treatment and media campaigns are supported, smoking prevalence and SADs will fall substantially in European countries.

Keywords: Europe; Smoking prevalence; simulation models; smoking-attributable mortality; tobacco control policy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Europe / epidemiology
  • Health Policy*
  • Humans
  • Markov Chains
  • Models, Theoretical*
  • Prevalence
  • Smoking / economics*
  • Smoking / mortality
  • Smoking Prevention*
  • Taxes*