COST-EFFECTIVENESS ANALYSIS (CEA) OF A TOBACCO INITIATION INTERVENTION FOR COLLEGE STUDENTS IN TÜRKİYE

Yıl 2024, Sayı: 43, 165 – 174, 05.05.2024

İbrahim Demir , Elif Gül Köse

https://doi.org/10.18092/ulikidince.1439541

Öz

Ekonomik değerlendirme, kamu kaynaklarının verimli kullanılması ve özellikle yeni programların yaygınlaştırılması kararlarında önemlidir. Bu çalışma, Ankara, Türkiye’deki üniversite öğrencilerine yönelik 27 aylık bir tütün kontrolü projesinin tam ekonomik değerlendirmesini sunmaktadır. Son yıllarda artan yaygınlık nedeniyle Türkiye’de genç yetişkinler arasında tütün kullanımı özellikle endişe vericidir. Çalışma, örneklem ve nüfus düzeyinde göreceli maliyet etkinlik oranlarını (MEO) hesaplamaktadır. Farkındalık göstergesi olarak hatırlama için örneklem düzeyindeki MEO ₺680,91 iken engellenen başlama için MEO ₺2.138,05 olarak tespit edilmiştir. Nüfusa ekstrapole edilmiş MEO’lar ise sırasıyla ₺34,96 ve ₺105,44’tür. Proje anketinde çapraz kontrol maksadıyla sorulan etkililik sorusuna verilen yanıt, proje müdahalelerinin 571 hiç tütün kullanmamış öğrencinin tütüne başlamasını önlediği tespit edilmiştir. Buna göre, engellenen başlatma MEO’su ₺2.289,18’dir ki bu rakam ₺2.138,05’lik MEO’ya oldukça yakındır. Araştırmada stantların en yüksek, kısa videoların ise en az maliyet etkili müdahale öğesi olduğu bulgusuna ulaşılmıştır. Çalışmanın bulguları kaynak tahsisine daha iyi rehberlik edecek ve projenin Türkiye’deki tüm yükseköğretim kurumlarına yaygınlaştırılmasına yönelik politika kararlarında etkili olacaktır.

Anahtar Kelimeler

Tütün Kullanımı, Tütün Yükü, Tütün Kontrolü, Ekonomik Değerlendirme, Maliyet Etkililik Analizi

Destekleyen Kurum

TÜBİTAK

Proje Numarası

220K048

Kaynakça

• Afanador, L. D., Radi, D. S., Pinto, L. E., Pinzón, C., and Carreño, M. F. (2014). Sociocultural Determinants of Tobacco Smoking Initiation among University Students in Bucaramanga, Colombia, 2012. International Journal of Preventive Medicine, 5, 1106-1112.
• CDC. (2016). CDC Fact Sheet: Health Effects of Cigarette Smoking. Center for Disease Control and Prevention.
• Çeken, B. (2016). Görsel Cinas ve Sosyal Afişlerde Kullanımı. Akdeniz Sanat Dergisi.
• Chaloupka, F.J., Straif, K., and Leon, M.E. (2010). Effectiveness of Tax and Price Policies in Tobacco Control. Tobacco Control, 20, 235 – 238.
• Demir, İ., Atasoy, E., Süsen, Y., Köse, E. G. (2024). Üniversite Öğrencilerinin Tütün ve Tütün Ürünlerine Başlamaya Yönelik Deneyim ve Görüşlerinin İncelenmesi. Külliye, 5(1), 59-83. https://doi.org/10.48139/aybukulliye.1318815
• Dilley, J. A., Harris, J. R., Boysun, M. J., and Reid, T. R. (2012). Program Policy and Price Interventions for Tobacco Control: Quantifying the Return on Investment of a State Tobacco Control Program. American Journal of Public Health.
• Drummond, M. F., Sculpher, M. J., Claxton, K., Stoddart, G. L., and Torrance, G. W. (2015). Methods for the Economic Evaluation of Health Care Programmes. Oxford University Press.
• Ehses, H. H. (1984). Representing Macbeth: A Case Study in Visual Rhetoric. Design Issues.
• Elders, M. J. (1997). Preventing Tobacco Use among Young People: A Report of the Surgeon General. Diane Publishing.
• Farajat, M., Hoving, C., and De Vries, H. (2011). Psychosocial Determinants of Cigarette Smoking among University Students in Jordan. Journal of Developmental Origins of Health and Disease, 2(3), 152-161.
• Farrelly, M. C., Duke, J. C., Nonnemaker, J., MacMonagle, A. J., Alexander, T. N., Zhao, X., and Allen, J. A. (2017). Association between the Real Cost Media Campaign and Smoking Initiation among Youths. Morbidity and Mortality Weekly Report.
• Gold, H.T. (2018). Cost-Effectiveness Analysis in Implementation Science. Oxford Medicine Online.
• Heller, S., and Vienne, V. (2012). 100 Ideas that Changed Graphic Design. London: Laurence King.
• Hossain, S., Hossain, S., Ahmed, F., Islam, R., Sikder, T., and Rahman, A. (2017). Prevalence of Tobacco Smoking and Factors Associated with the Initiation of Smoking among University Students in Dhaka, Bangladesh. Central Asian journal of global health, 6(1).
• IHME. (2019). Global Burden of Disease Collaborative Network. Global Burden of Disease Study 2019 (GBD 2019) Results. Seattle, United States. Retrieved from https://vizhub.healt hdata.org/gbd-results/
• Jiang, X., Jackson, L.J., Syed, M.A., Avşar, T.S., and Abdali, Z. (2022). Economic Evaluations of Tobacco Control Interventions in Low -and Middle-Income Countries: A Systematic Review. Addiction.
• Jha, P., Ramasundarahettige, C., Landsman, V., Rostron, B., Thun, M., Anderson, R. N., … and Peto, R. (2013). 21st-Century Hazards of Smoking and Benefits of Cessation in the United States. New England Journal of Medicine, 368(4), 341-350.
• Kahende, J.W., Loomis, B.R., Adhikari, B.R., and Marshall, L.L. (2008). A Review of Economic Evaluations of Tobacco Control Programs. International Journal of Environmental Research and Public Health, 6, 51 – 68.
• Kılıç, R. (1997). Görsel Öğretim Materyalleri Tasarım İlkeleri. Milli Eğitim Dergisi.
• Leão, T., Kunst, A.E., and Perelman, J. (2017). Cost-Effectiveness of Tobacco Control Policies and Programmes Targeting Adolescents: A Systematic Review. The European Journal of Public Health, 28, 39 – 43.
• Levin, H., & McEwan, P.J. (2003). Cost-Effectiveness Analysis as an Evaluation Tool.
• Miller, L. S., Max, W., Sung, H. Y., Rice, D., and Zaretsky, M. (2010). Evaluation of the Economic Impact of California's Tobacco Control Program: A Dynamic Model Approach. Tobacco Control, 19(Suppl 1), i68-i76.
• Nelson, K.E., & Nevel, W.C. (1979). Cost-Effectiveness Analysis of Publıc Transit Systems. Traffic Quarterly, 33.
• O'Neill, D.D., Westerman, D.P., & Sacco, W. (1966). Cost-Effectiveness Analyses.
• Poscia, A., Parente, P., Frisicale, E. M., Teleman, A. A., Waure, C. D., and Pietro, M. L. (2015). Risky Behaviours among University Students in Italy. Annali Dell'Istituto Superiore di Sanita, 51, 111-115.
• Shearer, J., and Shanahan, M. (2006). Cost Effectiveness Analysis of Smoking Cessation Interventions. Australian and New Zealand Journal of Public Health, 30.
• Staten, R. R., Noland, M., Rayens, M. K., Hahn, E., Dignan, M., and Ridner, S. L. (2007). Social Influences on Cigarette Initiation among College Students. American Journal of Health Behavior, 31(4), 353-362.
• Tekbaş, F., Ceylan, S., Oğur, R., Açıkel, C., and Göçgeldi, E. (2005). Sağlık Eğitiminde Kullanılan Materyaller ve Etkin Kullanımı.
• WHO. (2008). WHO Report on the Global Tobacco Epidemic, 2008: The MPOWER Package. World Health Organization.
• WHO. (2011). WHO Report on the Global Tobacco Epidemic, 2011: Warning about the Dangers of Tobacco. World Health Organization.
• WHO. (2016). WHO Updated Fact Sheet on Tobacco, 2016. World Health Organization.

COST-EFFECTIVENESS ANALYSIS (CEA) OF A TOBACCO INITIATION INTERVENTION FOR COLLEGE STUDENTS IN TÜRKİYE

Yıl 2024, Sayı: 43, 165 – 174, 05.05.2024

İbrahim Demir , Elif Gül Köse

https://doi.org/10.18092/ulikidince.1439541

Öz

Economic evaluation is essential for the efficient use of public resources and, especially, for the scale-up
Economic evaluation is essential for the efficient use of public resources and, especially, for the scale-up decisions of the new programs. This study provides a full economic evaluation of a 27-month tobacco control project for college students in Ankara, Türkiye. Tobacco use is costly due to disease/disability, premature death, and associated economic burden. Tobacco use among young adults is of particular concern in Türkiye because of rising prevalence in recent years. The study calculates the sample and population level relative cost-effectiveness ratio (CER) using recall for the interventions implemented in the project. Study found that while the sample-level CER for recall was ₺680,91 and for prevented initiation was ₺2,138.05, the extrapolated CERs were ₺34,96 and ₺105.44, respectively. Reponse to a direct cross-check project effectiveness question in the questionnaire indicated that the project prevented the initiation of 571 never-smoked students. Given this, prevented initiation CER is ₺2,289.18, which is quite similar to survey aggregate CER of ₺2,138.05 for preveneted initiation. Study also found that booth administered during special day was the most cost-effective intervention item while short videos were the least cost-effective ones. The findings of the study will better guide resource allocation and will be instrumental in policy decisions for scaling up the project to all higher education institutions in Türkiye.

Anahtar Kelimeler

Tobacco Use, Tobacco Burden, Tobacco Control, Economic Evaluation, Cost-Effectiveness Analysis

Proje Numarası

220K048

Kaynakça

• Afanador, L. D., Radi, D. S., Pinto, L. E., Pinzón, C., and Carreño, M. F. (2014). Sociocultural Determinants of Tobacco Smoking Initiation among University Students in Bucaramanga, Colombia, 2012. International Journal of Preventive Medicine, 5, 1106-1112.
• CDC. (2016). CDC Fact Sheet: Health Effects of Cigarette Smoking. Center for Disease Control and Prevention.
• Çeken, B. (2016). Görsel Cinas ve Sosyal Afişlerde Kullanımı. Akdeniz Sanat Dergisi.
• Chaloupka, F.J., Straif, K., and Leon, M.E. (2010). Effectiveness of Tax and Price Policies in Tobacco Control. Tobacco Control, 20, 235 – 238.
• Demir, İ., Atasoy, E., Süsen, Y., Köse, E. G. (2024). Üniversite Öğrencilerinin Tütün ve Tütün Ürünlerine Başlamaya Yönelik Deneyim ve Görüşlerinin İncelenmesi. Külliye, 5(1), 59-83. https://doi.org/10.48139/aybukulliye.1318815
• Dilley, J. A., Harris, J. R., Boysun, M. J., and Reid, T. R. (2012). Program Policy and Price Interventions for Tobacco Control: Quantifying the Return on Investment of a State Tobacco Control Program. American Journal of Public Health.
• Drummond, M. F., Sculpher, M. J., Claxton, K., Stoddart, G. L., and Torrance, G. W. (2015). Methods for the Economic Evaluation of Health Care Programmes. Oxford University Press.
• Ehses, H. H. (1984). Representing Macbeth: A Case Study in Visual Rhetoric. Design Issues.
• Elders, M. J. (1997). Preventing Tobacco Use among Young People: A Report of the Surgeon General. Diane Publishing.
• Farajat, M., Hoving, C., and De Vries, H. (2011). Psychosocial Determinants of Cigarette Smoking among University Students in Jordan. Journal of Developmental Origins of Health and Disease, 2(3), 152-161.
• Farrelly, M. C., Duke, J. C., Nonnemaker, J., MacMonagle, A. J., Alexander, T. N., Zhao, X., and Allen, J. A. (2017). Association between the Real Cost Media Campaign and Smoking Initiation among Youths. Morbidity and Mortality Weekly Report.
• Gold, H.T. (2018). Cost-Effectiveness Analysis in Implementation Science. Oxford Medicine Online.
• Heller, S., and Vienne, V. (2012). 100 Ideas that Changed Graphic Design. London: Laurence King.
• Hossain, S., Hossain, S., Ahmed, F., Islam, R., Sikder, T., and Rahman, A. (2017). Prevalence of Tobacco Smoking and Factors Associated with the Initiation of Smoking among University Students in Dhaka, Bangladesh. Central Asian journal of global health, 6(1).
• IHME. (2019). Global Burden of Disease Collaborative Network. Global Burden of Disease Study 2019 (GBD 2019) Results. Seattle, United States. Retrieved from https://vizhub.healt hdata.org/gbd-results/
• Jiang, X., Jackson, L.J., Syed, M.A., Avşar, T.S., and Abdali, Z. (2022). Economic Evaluations of Tobacco Control Interventions in Low -and Middle-Income Countries: A Systematic Review. Addiction.
• Jha, P., Ramasundarahettige, C., Landsman, V., Rostron, B., Thun, M., Anderson, R. N., … and Peto, R. (2013). 21st-Century Hazards of Smoking and Benefits of Cessation in the United States. New England Journal of Medicine, 368(4), 341-350.
• Kahende, J.W., Loomis, B.R., Adhikari, B.R., and Marshall, L.L. (2008). A Review of Economic Evaluations of Tobacco Control Programs. International Journal of Environmental Research and Public Health, 6, 51 – 68.
• Kılıç, R. (1997). Görsel Öğretim Materyalleri Tasarım İlkeleri. Milli Eğitim Dergisi.
• Leão, T., Kunst, A.E., and Perelman, J. (2017). Cost-Effectiveness of Tobacco Control Policies and Programmes Targeting Adolescents: A Systematic Review. The European Journal of Public Health, 28, 39 – 43.
• Levin, H., & McEwan, P.J. (2003). Cost-Effectiveness Analysis as an Evaluation Tool.
• Miller, L. S., Max, W., Sung, H. Y., Rice, D., and Zaretsky, M. (2010). Evaluation of the Economic Impact of California's Tobacco Control Program: A Dynamic Model Approach. Tobacco Control, 19(Suppl 1), i68-i76.
• Nelson, K.E., & Nevel, W.C. (1979). Cost-Effectiveness Analysis of Publıc Transit Systems. Traffic Quarterly, 33.
• O'Neill, D.D., Westerman, D.P., & Sacco, W. (1966). Cost-Effectiveness Analyses.
• Poscia, A., Parente, P., Frisicale, E. M., Teleman, A. A., Waure, C. D., and Pietro, M. L. (2015). Risky Behaviours among University Students in Italy. Annali Dell'Istituto Superiore di Sanita, 51, 111-115.
• Shearer, J., and Shanahan, M. (2006). Cost Effectiveness Analysis of Smoking Cessation Interventions. Australian and New Zealand Journal of Public Health, 30.
• Staten, R. R., Noland, M., Rayens, M. K., Hahn, E., Dignan, M., and Ridner, S. L. (2007). Social Influences on Cigarette Initiation among College Students. American Journal of Health Behavior, 31(4), 353-362.
• Tekbaş, F., Ceylan, S., Oğur, R., Açıkel, C., and Göçgeldi, E. (2005). Sağlık Eğitiminde Kullanılan Materyaller ve Etkin Kullanımı.
• WHO. (2008). WHO Report on the Global Tobacco Epidemic, 2008: The MPOWER Package. World Health Organization.
• WHO. (2011). WHO Report on the Global Tobacco Epidemic, 2011: Warning about the Dangers of Tobacco. World Health Organization.
• WHO. (2016). WHO Updated Fact Sheet on Tobacco, 2016. World Health Organization.

Toplam 31 adet kaynakça vardır.

Ayrıntılar

Kaynak Göster

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