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The potential impact and cost-effectiveness of tobacco reduction strategies for tuberculosis prevention in Canadian Inuit communities

BMC Medicine Feb 10, 2019

N’Diaye DS, et al. - Given that tobacco use is an important risk factor for tuberculosis (TB), and over 60% of Inuit adults smoke, researchers investigated how a reduction in tobacco use may change the TB-related outcomes and costs in Inuit communities. They estimated the initial prevalence of latent TB infection (LTBI) using a transmission model and then performed decision analysis modelling, to conduct a cost-effectiveness analysis that compared the current standard of care for management of TB and LTBI without additional tobacco reduction intervention (Status Quo) with (1) increased tobacco taxation, (2) pharmacotherapy and counselling for smoking cessation, (3) pharmacotherapy, counselling plus mass media campaign, and (4) the combination of all these. As per outcomes, the combined strategy could reduce active TB cases by 6.1% and TB deaths by 10.4% over 20 years, relative to the status quo. Increased taxation was identified to be the only cost-saving strategy.
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