BACKGROUND: The widespread availability of tobacco products fuels preventable health burden in Belgium, representing a lasting challenge to public health. To address this, the Belgian inter-federal tobacco plan introduces a policy to reduce availability by closing specific sales channels. This study aims to estimate the avoidable health burden of this policy using two different modeling methods: comparative risk assessment (CRA) and system dynamics (SD).
METHODS: The CRA approach estimates the direct impact of reduced tobacco availability on smoking prevalence and related health outcomes by calculation of the potential impact fraction. The SD model applies a dynamic systems approach to simulate interactions between tobacco availability, smoking behaviors, and health outcomes. Key data sources include national Belgium health interview survey, literature-derived data, population projections and mortality data. Outcome measures include reductions in smoking prevalence attributable to the policy as well as avoidable disease burden in terms disability adjusted life years (DALY).
RESULTS: Both models estimated a substantial reduction in the tobacco-related burden. The CRA model estimated 2300 avoidable DALY due to lung cancer in 2040 while the SD model projected 2800 less overall deaths among smokers in 2040. The SD model provides complementary insights, highlighting potential delays in policy impact and long-term benefits for population health. A comparative analysis underscores the strengths and limitations of each method in capturing different dimensions of the policy’s effects.
CONCLUSIONS: The findings indicate that reducing tobacco availability through targeted sales channel closures can yield significant health benefits, including reduced mortality and disease burden. This study highlights the utility of combining CRA and SD approaches for comprehensive evaluations of policies. Policymakers should consider these insights to enhance the effectiveness of tobacco control strategies and monitor their long-term impact on public health outcomes.