Economic aspects of addiction policy.

One definition of policy or government action in the Oxford English Dictionary is "craftiness" i.e. cunning or deceit. Such qualities have to be employed by governments because of the potential vote-losing effects of radical addiction policies. Health promotion, in relation to addictive substances such as alcohol and tobacco in particular, involves a trade-off between the costs of such policies, especially to industry (which seeks regulation to protect itself from competitors), and the benefits--improvements in the quality and length of life. Measures of such benefits (quality-adjusted life-years or QALYs) are available now to use in the evaluation of competing health promotion policies to determine their efficiency at the margin. Analysis of the market for tobacco indicates that consumption has been falling generally in the UK except among teenagers who appear to be the target of the industry's advertising and sponsorship efforts. This fall in consumption appears to be explained by health promotion rather than the active use of fiscal instruments of control. The recognition of the health effects of passive smoking and the impact of advertising and sponsorship, especially on the young, are policy areas requiring careful review and the evaluation of the costs and benefits of competing policies.(ABSTRACT TRUNCATED AT 250 WORDS)