Impact of tobacco control policies on smoking-related cancer incidence in Germany 2020 to 2050 - a simulation study
Menée à l'aide d'une modélisation et de données 2017 du registre allemand des cancers notamment, cette étude estime, jusqu'en 2050 et en fonction du sexe, la part évitable des cancers liés au tabac si une combinaison de politiques de lutte contre le tabagisme était mise en œuvre en Allemagne
Background: Germany is known for its weak tobacco control. We aimed to provide projections of potentially avoidable cancer cases under different tobacco control policy intervention scenarios. Methods: To estimate numbers and proportions of potentially avoidable cancer cases under different policy intervention scenarios (cigarette price increases, comprehensive marketing ban, plain packaging), we calculated cancer site-specific potential impact fractions by age, sex and year of study period (2020-2050), considering latency periods between reduction in smoking prevalence and manifestation in declining cancer excess risks. To obtain estimates of future incident case numbers, we assumed a continuation of recent smoking trends, and combined German cancer registry data with forecasted population sizes, published effect sizes, and national daily smoking prevalence data. Results: Over a 30-year horizon, an estimated 13.3% (men 14.0%, women 12.2%) of smoking-related cancer cases could be prevented if a combination of different tobacco control policies were to be implemented in Germany, with repeated price increases being the most effective single policy (men 8.5%, women 7.3%). Extensive sensitivity analyses indicated that the model is fairly robust. Conclusions: Our results suggest that the expected cancer incidence in Germany could be considerably reduced by implementing tobacco control policies as part of a primary cancer prevention strategy. Impact: Our straightforward modelling framework enables a comparison of the impact of different health policy measures. To further accelerate the currently observed tentative trend of declining smoking prevalence in Germany and thereby curtail on smoking-related cancer incidence, there is a great need to urgently intensify efforts in tobacco control.