WIREDGOV

A new interactive tool developed by NICE and Brunel University will help local authorities count the cost of tobacco-related harm in their communities. The tool also models the longer-term cash savings that authorities can expect by putting tobacco control strategies in place.

Local authorities have a responsibility to address health inequalities, and smoking is the primary reason for the gap in healthy life-expectancy between rich and poor. Tobacco use is also the single greatest cause of preventable deaths in England - killing over 80,000 people per year.

The economic cost of tobacco is huge, due not only to the 1.5 million hospital admissions connected to smoking, but to loss of productivity from absenteeism, smoking-related fires, cleaning up cigarette butts and passive smoking.

There are a number of different strategies local commissioners can adopt to help smokers quit, and over the years NICE has developed guidance on the effectiveness and cost effectiveness of various interventions, including pharmacotherapies and support and advice for smokers. For the first time, local government commissioners and Directors of Public Health can use this tool to calculate the cost, and cost savings over different timescales, of a package of different interventions.

"To really make the business case for smoking cessation in a local area, interventions must demonstrate that they make a difference, both in terms of effectiveness and cost," said Professor Mike Kelly, Director of the Centre for Public Health Excellence at NICE."Most of the smoking interventions recommended by NICE are considered highly cost effective and some are even cost saving. This new tool, combined with NICE's guidance, will go a long way to helping commissioners do this."

The Tobacco Return on Investment Tool is a Microsoft Excel-based program that evaluates a portfolio of tobacco control interventions and in different payback timescales. Packages of interventions can be mixed and matched to see which intervention portfolio or package provides the best 'value for money', compared with 'no-services' or any other specified package.

Produced for NICE by the Health Economics Research Group (HERG) at Brunel University, the tool is to support commissioners and policy makers, in local authorities and the NHS, in their investment decisions. Users can select an area of interest using drop down menus, and the tool will automatically estimate the smoking and ex-smoking populations in each local government area, based on up-to-date statistics. This is then used to model the impact of smoking, and the proposed interventions that can be used, taking into account short-, medium- and long-term events.

"In the current financial climate, the question 'is this value for money?' is the first one asked when making decisions about public health initiatives," said Felicity Owen, Director of Public Health for Cornwall and the Isles of Scilly. "To be able to describe, with some certainty, the cost to communities as well as the potential savings that can be made will be very helpful for making the case for investing in and prioritising tobacco control measures."

The return on investment tool builds on previous work including work undertaken by Brunel University on behalf of Tobacco Free Futures, Fresh Smoke Free North East and Smoke Free South West. The tool is accompanied by a package of support materials, including a user guide and technical report, which can also be downloaded from the NICE website.