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EQUIPT: protocol of a comparative effectiveness research study evaluating cross-context transferability of economic evidence on tobacco control
  1. Subhash Pokhrel1,
  2. Silvia Evers2,3,
  3. Reiner Leidl4,
  4. Marta Trapero-Bertran5,
  5. Zoltan Kalo6,
  6. Hein de Vries7,
  7. Andrea Crossfield8,
  8. Fiona Andrews9,
  9. Ailsa Rutter10,
  10. Kathryn Coyle1,
  11. Adam Lester-George11,
  12. Robert West12,13,
  13. Lesley Owen14,
  14. Teresa Jones1,
  15. Matthias Vogl4,
  16. Cornel Radu-Loghin15,
  17. Zoltan Voko6,
  18. Mirjana Huic16,
  19. Doug Coyle1,17
  1. 1Health Economics Research Group, Institute of Environment, Health and Societies, Brunel University London, London, UK
  2. 2Maastricht University, Caphri School of Public Health and Primary Care, Maastricht, The Netherlands
  3. 3Trimbos Institute, Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
  4. 4Institute of Health Economics and Health Care Management, Helmholtz Zentrum München, German Research Center for Environmental Health, Member of the German Center for Lung Research (DZL), Munich, Germany
  5. 5Universitat Pompeu Fabra, Barcelona, Spain
  6. 6Faculty of Social Sciences, Department of Health Policy and Health Economics, Eötvös Loránd University, and Syreon Research Institute, Budapest, Hungary
  7. 7Maastricht University, Caphri School of Public Health and Primary Care, Maastricht, The Netherlands
  8. 8Tobacco Free Futures, Manchester, UK
  9. 9Smokefree South West, Bristol, UK
  10. 10FRESH Smokefree North East, Durham, UK
  11. 11LeLan (Ltd) Solutions, Bristol, UK
  12. 12Department of Epidemiology and Public Health, Health Behaviour Research Centre, University College London, London, UK
  13. 13National Centre for Smoking Cessation and Training, London, UK
  14. 14National Institute for Health and Care Excellence, London, UK
  15. 15European Network for Smoking Prevention, Brussels, Belgium
  16. 16Department for Development, Research and Health Technology Assessment, Agency for Quality and Accreditation in Health Care and Social Welfare, Zagreb, Croatia
  17. 17Department of Epidemiology & Community Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Canada
  1. Correspondence to Dr Subhash Pokhrel; Subhash.Pokhrel{at}


Introduction Tobacco smoking claims 700 000 lives every year in Europe and the cost of tobacco smoking in the EU is estimated between €98 and €130 billion annually; direct medical care costs and indirect costs such as workday losses each represent half of this amount. Policymakers all across Europe are in need of bespoke information on the economic and wider returns of investing in evidence-based tobacco control, including smoking cessation agendas. EQUIPT is designed to test the transferability of one such economic evidence base—the English Tobacco Return on Investment (ROI) tool—to other EU member states.

Methods and analysis EQUIPT is a multicentre, interdisciplinary comparative effectiveness research study in public health. The Tobacco ROI tool already developed in England by the National Institute for Health and Care Excellence (NICE) will be adapted to meet the needs of European decision-makers, following transferability criteria. Stakeholders' needs and intention to use ROI tools in sample countries (Germany, Hungary, Spain and the Netherlands) will be analysed through interviews and surveys and complemented by secondary analysis of the contextual and other factors. Informed by this contextual analysis, the next phase will develop country-specific ROI tools in sample countries using a mix of economic modelling and Visual Basic programming. The results from the country-specific ROI models will then be compared to derive policy proposals that are transferable to other EU states, from which a centralised web tool will be developed. This will then be made available to stakeholders to cater for different decision-making contexts across Europe.

Ethics and dissemination The Brunel University Ethics Committee and relevant authorities in each of the participating countries approved the protocol. EQUIPT has a dedicated work package on dissemination, focusing on stakeholders’ communication needs. Results will be disseminated via peer-reviewed publications, e-learning resources and policy briefs.

  • return on investment
  • tobacco
  • smoking cessation
  • cost-effectiveness

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