A Cost-Effectiveness Analysis of Tobacco Generational Endgame Scenarios in Malaysia: A Comparison of a Total Ban versus Smokeless-Only Policies

Wan Puteh, Sharifa Ezat; Binti Ruslan, Nur Farihin

doi:10.31557/APJCP.2026.27.5.1615

A Cost-Effectiveness Analysis of Tobacco Generational Endgame Scenarios in Malaysia: A Comparison of a Total Ban versus Smokeless-Only Policies

Document Type : Research Articles

Authors

Sharifa Ezat Wan Puteh ¹
Nur Farihin Binti Ruslan ¹^{, 2}

¹ Department of Public Health Medicine, Medical Faculty, Universiti Kebangsaan Malaysia, Selangor, Malaysia.

² Ministry of Health, Malaysia.

10.31557/APJCP.2026.27.5.1615

Abstract

Introduction: The use of tobacco products is associated with the treatment costs of lung-related diseases. The Tobacco Generational Endgame (GEG) strategy can improve efficiency in managing medical costs. Methods: Three GEG scenarios were identified. In Scenario 1, the GEG policy was not implemented. Scenario 2 prohibited the use of all tobacco products. Scenario 3 allowed only smokeless tobacco products. Secondary data obtained from the Ministry of Health (MOH) Malaysia were analysed using the Incremental Cost-Effectiveness Ratio (ICER) and sensitivity analysis. Results: In 2019, the Ministry of Health (MOH) spent MYR 71,527,032.50 on the treatment of chronic obstructive pulmonary disease and MYR 38,112,229.30 on lung cancer. The estimated annual cost for the Tobacco Control Programme was MYR 142,389,194.40. Analysis shows that Scenario 3 is the most cost-effective. Conclusions: The results of this study can serve as a guide for the government in formulating policies that maximise the benefits of GEG implementation.

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