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Higher cigarette prices could help millions

A substantial increase in cigarette prices could help millions of people around the world avoid poor health and extreme poverty, according to research published by the BMJ. The findings show that people on low incomes have the most to gain. Researchers from the Global Tobacco Economics Consortium and the University of Toronto set out to predict the effect of a 50% increase in cigarette prices on health, poverty and financial protection in 13 middle income countries with a total of 500 million male smokers. The authors used a simple compartmental model, developed by the Disease Control Priorities Project and building on an earlier poverty and tobacco taxation analysis by the Asian Development Bank, to measure the impact of quitting, by age and income group, on life years gained, treatment costs averted, catastrophic medical costs and poverty avoided, and additional tax revenue. Prices were assumed to have been raised by increasing tobacco excise rates to reach the target price in each country. The investigators found that a 50% price increase would lead to about 450 million years of life being gained in the 13 countries as the result of quitting, half of them in China. Across all countries, men in the lowest income group (poorest 20% of the population) would gain seven times as many life years as men in the top income group (richest 20% of the population; 155 v 23 million life years). The average number of life years gained as the result of quitting by smokers in the lowest income group was five times that of those in the top group (1.46 v 0.23 life years). Of the $157 billion in averted treatment costs, the savings were almost five times as great in the lowest as in than the top income group ($46 billion v $10 billion). In seven countries without universal health coverage, about 15.5 million men would avoid catastrophic medical costs. As a result, 8.8 million men, half in the lowest income group, would avoid falling below the World Bank definition of extreme poverty. Overall, 31% of the life years saved and 29% of the averted disease costs and medical costs would be in the lowest income group, which would, however, contribute only 10% of the additional $122 billion in taxes collected.

https://www.bmj.com/content/361/bmj.k1162

Mental disorders leading cause of illness in children globally

Researchers from the Université Paris–Saclay in France have found that although global rates of mental disorders in children have remained stable over time, they will become the main causes of disease in children aged 4–15 years as a consequence of the decline in the prevalence of infectious diseases. The study, published in Child and Adolescent Psychiatry and Mental Health, described the prevalence of mental disorders among children aged 5–14 years in each of the six regions of the World Health Organization – Africa, the Americas, South-East Asia, Europe, the East Mediterranean, and the West Pacific Region. They found that even in emerging regions, the prevalence of mental disorders was high and constant over time. In 2000, mental disorders ranked third among the causes of disability-adjusted life-years (DALYs) — years of healthy life lost because of disease or disability — in the Americas and Europe; by 2015, mental disorders were the second greatest cause of DALYs here as the impact of infectious diseases decreased. This change from infectious diseases to mental disorders as the main cause of DALYs in children is termed an epidemiological transition. The impact of mental disorders on child health will increase in importance as more countries undergo this transition from infectious diseases to mental disorders as major causes of ill health. In most WHO regions, four mental disorders ranked among the 20 diseases associated with the most DALYs: conduct disorders, anxiety disorders, major depressive disorders, and autism–Asperger syndrome. Among boys, the most common mental disorders associated with DALYs were conduct disorders, autism–Asperger syndrome and anxiety disorders; among girls, they were anxiety disorders, conduct disorders and major depressive disorder. In addition to the change over time, the authors also noted the effect of income: regions with the highest gross domestic product had fewer problems with infectious diseases and more with mental disorders.

https://capmh.biomedcentral.com/articles/10.1186/s13034-018-0225-4