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Cost-Benefit-Analysis of No-smoking Policy Instruments---Case Study of Beijing

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Title: Cost-Benefit-Analysis of No-smoking Policy Instruments---Case Study of Beijing


1
Cost-Benefit-Analysis of No-smoking Policy
Instruments---Case Study of Beijing
  • DAI Yixin1 XUE Lan1 HU Yinglian2
  • 1 School of Public Policy Management,
    Tsinghua University
  • 2 Department of Social Cultural Studies,
    Chinese Academy of Governance (CAG)

2
WHO Framework Convention on Tobacco Control
(FCTC) 8.2
  • This is the responsibility clearly given by the
    WHO Framework Convention on Tobacco Control
    (FCTC) to all parties which should actively take
    measures and reinforce effective legislation,
    administrative regulations within jurisdiction of
    courts, so as to prevent from exposure to
    second-hand smoke at indoor working places,
    public vehicles and indoor public places, as well
    as other pubic places at a appropriate time.

3
Tobacco Control Work by Chinese Government
  • On Nov.10, 2003, Chinese government signed the
    Convention officially
  • On August 28, 2005, The Convention was adopted by
    Standing Committee of the 10th National People's
    Congress
  • In recent years, under joint endeavor by
    different regions, relevant departments and the
    whole society, China strengthen its effort in
    tobacco control increasingly. Tobacco control
    theories, legislation, and policy systems have
    been established and improved persistently, hence
    guarantee a stable tobacco control status and a
    favorable turn.

4
Non-smoking Practice at Public Places in Beijing
  • On Dec.21, 1995, the Provision on No-smoking at
    Public Places in Beijing (here-in-after referred
    as Provision) was adopted by standing committee
    of the 10th Peoples Congress of Beijing
    Municipality
  • On March 24, 2008, Special Provision on
    No-smoking Scale of Public Places in Beijing
    Municipality was adopted by the 2nd meeting of
    standing committee by Beijing Municipal
    Government (here-in-after referred as Special
    Provision)

5
I. Key Topic
  • How to assess effectiveness of no-smoking policy
    implementation at public places in Beijing?

6
II. Theory Framework
  • (1)Effectiveness assessment of provision
    implementation
  • (2)Efficiency assessment of provision
    implementation
  • (3)Application range assessment of provision
    implementation

7
Table 1 Assessment Indexes System of No-smoking
Efficiency at Public Places
Primary Index Secondary Index Tertiary Index
Cost Direct cost of obliged institutions Daily management fee
Cost Direct cost of obliged institutions facilities reform and maintenance fee
Cost Direct cost of obliged institutions Advocacy cost
Cost Direct cost of obliged institutions reviewer allowances
Cost Direct cost of regulated implementing institutions allocated funds
Cost Direct cost of regulated implementing institutions self-funded funds
Cost Indirect cost tobacco sales revenue loss brought by smoking ban
Cost Indirect cost tariff loss brought by smoking ban
Cost Indirect cost Profit loss of commercial places brought by smoking ban
Benefits Health benefit? medical benefits
Benefits Health benefit? life benefits
Benefits Safety benefit Reducing loss of fire due to reduce of smoking
8
III. Study Method
  • Sampling Areas
  • 2 urban districts, 2 suburban districts and 1
    outer suburban district
  • Sampling Targets
  • (1)Public places related to tobacco control work
  • (2)Legislation executive body
  • (3)defined obliger by regulation
  • Subjects
  • Provision and Special Provision
  • Methods
  • Cost-Benefit Analysis combined with multi-social
    scientific study methods including statistic
    analysis, expert opinion analysis
  • First-hand data
  • Questionnaire, including Questionnaire to obliged
    no-smoke institutions (n1244), Questionnaire to
    the public (n102), Questionnaire to provision
    applicable instructions (n21)
  • Second-hand data
  • Literatures home and abroad, literature of law
    and regulations, Beijing Social Economic
    Statistics Yearbook (20052008)

9
Figure 1 Diagram of Distribution Proportion of
Sampled Institution
10
IV. Assessment Findings
  • 4.1 Efficiency Assessment
  • 4.2 Effectiveness Assessment
  • 4.3 Scope Assessment

11
4.1 Efficiency Assessment
  • Significant achievements of tobacco control
  • Smoking prevalence among population aged 15 and
    above decreased to 26.9 of 2004 from 34.5 of
    1997.
  • The no-smoke prevalence at healthcare
    institutions, kindergartens, middle and primary
    schools, store, financial places, and post office
    reached 90 and above in 2008.
  • Difficulties in tobacco control work
  • More than 50 restaurants and internet bars
    didnt set up distinct smoking area or have no
    idea of whether they set up smoking area or not.
  • Only 33 obliged institutions set up obvious
    signs for No-smoking
  • Only 23.4 institutions realized complete
    quarantine between smoking area and no-smoking
    area
  • In house no smoking difficulties usually
    concentrated at elevator room and rest rooms.

12
4.1 Efficiency Assessment (continued)
  • Advocacy format adopted by obliged institutions
  • -Compared efficiency of different advocacy
    formats, mass media campaigns, including
    no-smoking advertisement, no-smoking bulletin
    board, dissemination of no-smoking brochures, are
    of highest efficiency, while internal meeting and
    website propaganda of related information
    achieved little effects.
  • Inspective behaviors of executive body
  • -restaurant is the most important and
    difficult places for tobacco control, in
    particular to restaurants of grade C and D.

13
Figure 2 Relationship between Expenditure and
Effect of Different Advocacy Formats
14
Table 2 Top 5 Categories of Highest Random
Inspection Frequency at Primary Level
Public Places Random Inspection Frequencies Ranking Of Frequencies Amount of Inspectors Ranking Of Inspectors
Restaurants of grade C and D 5.56 1 17.56 2
Nursery/kindergarten 4.25 2 8.11 15
Hotel 4.05 3 9.28 12
Restaurants of grade A and B 3.83 4 12.39 5
Guesthouse 3.64 5 11.75 6
15
Table 3 Top 5 Institutions with Most Law
Enforcement Inspectors at Primary Level
Public Places Random Inspection Frequencies Ranking of Frequencies Amount of Inspectors Ranking Of Inspectors
Classroom of commercial training 1.5 18 18.2 1
Restaurants of grade C and D 5.56 1 17.56 2
Concert Hall 0.86 26 13.2 3
Teaching Area in Campus 1.3 20 12.5 4
Restaurants of grade A and B 3.83 4 12.39 5
16
4.2 Effectiveness Assessment
  • Though assessment of cost of fulfilling
    obligations by obliged institutions, we found
  • (1)Viewing in aspect of mean cost of all kinds of
    obliged institutions, the absolute value was not
    high. Calculated according to total sample
    amount, annual expenditure of each institutions
    was less than 10, 000 Yuan.
  • (2) Viewing in aspect of expenditure structure,
    designating inspector and redecorating places
    accounted for the most proportion of no-smoking
    cost, in particular to employing part-time
    inspectors.
  • (3) Viewing in aspect of no-smoking expenditure
    of different institutions, administrative cost of
    complete no-smoking institutions was obviously
    higher than that of other institutions, while the
    in house no-smoking institutions of the least.

17
Table 4 No-smoking Cost Calculation Form of
Different Obliged Institutions
Cost Institution Category Gross Daily Administrative Cost (Yuan) Designating Inspector and Executing Function Cost Designating Inspector and Executing Function Cost Redecoration and Maintenance Cost (Yuan) In House Advocacy Education Cost (Yuan) Total Mean Cost (Yuan) Proportion Relationship
Cost Institution Category Gross Daily Administrative Cost (Yuan) Full-time Inspector (Yuan) Part-time Inspector (Yuan) Redecoration and Maintenance Cost (Yuan) In House Advocacy Education Cost (Yuan) Total Mean Cost (Yuan) Proportion Relationship
Completely No-smoking Institutions 1921.61 4896.57 8979.19 7064.98 837.91 23700.26 21
Partially No-smoking Institutions 1181.4 2954.84 2287.14 947.98 759.62 8130.98 7
In house 1644.87 731.39 2294 2310.19 344.68 7325.13 6
No-smoking Institutions 150 5 810 114.29 75 1154.29 1
18
Table 5 No-smoking Cost Calculation Form of
Different Obliged Institutions
Code of Institutions Gross Daily Administrative Cost (Yuan) Designating Inspector and Executing Function Cost Designating Inspector and Executing Function Cost Redecoration and Maintenance Cost (Yuan) In House Advocacy Education Cost (Yuan) Total Mean Cost (Yuan)
Code of Institutions Gross Daily Administrative Cost (Yuan) Full-time Inspector (Yuan) Part-time Inspector (Yuan) Redecoration and Maintenance Cost (Yuan) In House Advocacy Education Cost (Yuan) Total Mean Cost (Yuan)
Medical Institutions of Grade A 1010.00 125.57 2342.17 719.05 1932.00 6128.79
Nursery and Kindergarten of Grade B 604.12 0.00 1518.75 400.59 401.54 2924.99
Middle and Primary School of Grade C 1406.30 141.38 965.52 2170.6 848.89 5532.77
D Higher Education Colleges and other educational and training institutions 3500.00 0.00 0.00 2000.00 200.00 5700.00
E Recreation Places 663.64 0.00 162.58 932.27 703.06 2461.55
F Shops, Financial and Postal Offices 1499.10 1550.68 3582.12 876.69 743.08 7720.38
G Public Transportation Vehicles 480.00 1287.50 125.00 1460.00 220.00 3572.50
H Historic Preservations Open to Society 850.00 0.00 576.00 3100.00 300.00 4826.00
I Fitness Gyms 0.00 782.61 864.70 657.86 583.33 3264.69
J Restaurants and Internet Bars 671.22 366.76 187.70 863.19 637.20 2726.06
K Entertainment and Amusement Places 366.67 533.33 640.00 1175.00 280.00 2995.00
L Commercial Places providing accommodation services 2322.20 714.20 1401.97 1100.00 1026.63 6564.99
M Public Institutions 1644.87 88.36 384.90 771.73 344.68 3234.54
19
Cost of No-smoking Executing Body
  • Major funds and expenditure is supervised by
    Municipal Health Promotion Committees. There was
    distinct deficits in funds and expenditure of
    county level and below.
  • The total cost of executing body is far below
    than obliged institutions obliged cost.

20
Indirect Cost of Execution of Regulations
  • Tobacco sales revenue loss brought by smoking ban
  • Taxation loss brought by smoking ban
  • Profit loss of commercial places brought by
    smoking ban

21
Heath Benefits
  • Health benefits for smokers and passive smokers
    (namely, people who exposed to second-hand smoke)
  • Lung cancer
  • Cardiac diseases
  • Respiratory diseases

22
Table 6 Social Health Benefits (Yuan) Brought by
Smoking Ban
Disease Category Lung Cancer Cardiac Disease Respiratory Disease
Reduced deaths 362410 911931 441490
Mean medical cost 40,000100,000 40,000100,000 40000100000
Reduced medical expenditure 14,472,31741,044,087 36,420,21393,139,319 17,650,19949,014,819
Per capita death loss 337,283337,283 337,283337,283 337,283337,283
Reduced death loss 122,031,751138,434,834 307,098,197314,143,327 148,827,912165,318,779
Total health benefits 136,504,068179,478,921 343,518,40907,282,645 166,478,11014,333,598
23
Economic Effectiveness Manifested by Execution of
Provision
  • According on calculation by cost-benefit
    analysis, although Beijing Municipality expanded
    scope and input for execution of Provision, the
    derived benefits were higher than cost. The
    social net benefits was between 46,960,213 Yuan
    and162,776,294 Yuan in 2008.

Cost of Obliged Institutions (Yuan) Cost of Executing Body (Yuan) Indirect Cost (Yuan) Total Cost (Yuan)
599,551,324 6,576,110 0 606,127,434644,905,960
Health Benefits (Yuan) Safety Benefits (Yuan) Total Revenue (Yuan)
646,500,587801,095,164 10950 646,511,537801,106,144
24
4.3 Scope Assessment
  • Studies show that majority of Beijing citizens
    possess similar expectations defined by
    Convention
  • Over 50 general publics consent with contents
    defined by Provision, involving complete
    no-smoking at public places, in particular to
    public transportation vehicles, taxies, internet
    bars, and inside institutions.
  • Over 80 above mentioned general publics are more
    willing to go to public places after the scope of
    no-smoking been enlarged to overall no-smoking.
    Those who is more willing to go to entertainment
    places were less, of 62.

25
V. Main Conclusion and Policy Suggestions
  • Straighten out relationships between rights and
    obligations of each parties
  • Adjust and arrange scope and schedule of
    no-smoking at public places, according to
    assignment of rights and obligations
  • Develop tools for enforcement, and improve
    efficiency so as to achieve the goal

26
Requirements for Enforcement Differ upon
Different Place Categories
27
Figure 3 Analysis and Thoughts about Supervision
Model of Enforcement
28
Suggestions
  • Re-clarification of rights and obligations
    explicitly inform no-smoking obligations to
    obliged institutions and clarify legal
    responsibility its borne, in accordance with
    different categories of public places .
  • Supervise formulation of corresponding internal
    no-smoking management plan by obliged
    institutions within jurisdictional area, and
    inspect the implementation of no-smoking
    responsibility have been applied to specific
    staff .
  • Adjust no-smoking schedule according to public
    places of different categories allow for certain
    smoking rate to public places which aim at
    satisfying personal demands in short-term. As for
    these places, internal no-smoking regime should
    explicitly set up plan for smoking area and
    smoking room, and methods for examination and
    maintenance.
  • Adjust enforcement ways flexibly law
    enforcement agencies at primary level, such as
    District Office, should examine implementation
    work of plan by obliged institutions within
    jurisdictional area.
  • Further develop rating work of no-smoking at
    public places, connect no-smoking work of each
    institutions and public places together with
    sanitation inspection, and update ranks
    periodically according to no-smoking works of
    obliged institutions. At the same time, advocate
    no-smoking ranking of each institution to the
    public, so as to improve public awareness of
    meaning of different ranking level. Places which
    done bad no-smoking work shall be categorized
    into lower sanitation grade, and shall be
    upgraded when its no-smoking work return to
    normal.
  • Commend public places which is to satisfy
    individual demands for their excellent work of
    implementing no-smoking obligations, in
    particular to restaurants, and establish their
    public image. On the other hand, launch report
    system, so as to carry out supervision by peer
    competitor and consumers.

29
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