Objectives: We aimed to investigate the impact of different tobacco control interventions on health expectancies, i.e. healthy life years (HLY), total life expectancy (LE), and unhealthy life years (ULY).
Methods: Data on smoking and disability from participants of the 2013 Health Interview Survey in Belgium were used to estimate smoking and disability prevalence. Disability was defined based on the Global Activity Limitation Indicator (GALI). We used a dynamic model, DYNAMO-HIA, to quantify the impacts of risk factor changes on health expectancies, comparing the “business-as-usual” scenario with multiple alternative scenarios.
Results: The “business-as-usual” scenario estimated that a cohort of 15-year-old men/women is expected to live 49.89/51.59 years (y) without disability and 14.02y/17.23y with disability. The “smoking-free population” scenario added 3.62y/2.79y in HLY and reduced ULY by 0.78y/1.81y. The “zero (re)start probabilities and all smokers quit” scenario, potentially reflecting the impact of new policies that combine smoking cessation interventions with strategies for preventing smoking initiation, yielded the largest increase in HLY (2.98y/2.35y) and the greatest reduction in ULY (-0.76y/-1.63y). Every simulated scenario reported an increase in HLY and a decrease in ULY when compared to the reference scenario, only the effect size and the timing varied.
Conclusion: This study suggests that smoking yields major losses in terms of HLY and LE in Belgium. The comparisons of alternative scenarios with the “business-as-usual” scenario indicate that implementation of new anti-smoking strategies or stricter enforcement of already existing policy/intervention methods would potentially gain more HLY and reduce ULY.