The Economic Impact of Smoking and of Reducing Smoking Prevalence: Review of Evidence

BACKGROUND: Tobacco smoking is the cause of many preventable diseases and premature deaths in the UK and around the world. It poses enormous health- and non-health-related costs to the affected individuals, employers, and the society at large. The World Health Organization (WHO) estimates that, globally, smoking causes over US$500 billion in economic damage each year. OBJECTIVES: This paper examines global and UK evidence on the economic impact of smoking prevalence and evaluates the effectiveness and cost effectiveness of smoking cessation measures. STUDY SELECTION Search methods : We used two major health care/economic research databases, namely PubMed and the National Institute for Health Research (NIHR) database that contains the British National Health Service (NHS) Economic Evaluation Database; Cochrane Library of systematic reviews in health care and health policy; and other health-care-related bibliographic sources. We also performed hand searching of relevant articles, health reports, and white papers issued by government bodies, international health organizations, and health intervention campaign agencies. Selection criteria : The paper includes cost-effectiveness studies from medical journals, health reports, and white papers published between 1992 and July 2014, but included only eight relevant studies before 1992. Most of the papers reviewed reported outcomes on smoking prevalence, as well as the direct and indirect costs of smoking and the costs and benefits of smoking cessation interventions. We excluded papers that merely described the effectiveness of an intervention without including economic or cost considerations. We also excluded papers that combine smoking cessation with the reduction in the risk of other diseases. Data collection and analysis : The included studies were assessed against criteria indicated in the Cochrane Reviewers Handbook version 5.0.0. Outcomes assessed in the review : Primary outcomes of the selected studies are smoking prevalence, direct and indirect costs of smoking, and the costs and benefits of smoking cessation interventions (e.g., “cost per quitter”, “cost per life year saved”, “cost per quality-adjusted life year gained,” “present value” or “net benefits” from smoking cessation, and “cost savings” from personal health care expenditure). MAIN RESULTS: The main findings of this study are as follows: 1. The costs of smoking can be classified into direct, indirect, and intangible costs. About 15$151 billion. 2. The costs of smoking notwithstanding, it produces some potential economic benefits. The economic activities generated from the production and consumption of tobacco provides economic stimulus. It also produces huge tax revenues for most governments, especially in high-income countries, as well as employment in the tobacco industry. Income from the tobacco industry accounts for up to 7.4% of centrally collected government revenue in China. Smoking also yields cost savings in pension payments from the premature death of smokers. 3. Smoking cessation measures could range from pharmacological treatment interventions to policy-based measures, community-based interventions, telecoms, media, and technology (TMT)-based interventions, school-based interventions, and workplace interventions. 4. The cost per life year saved from the use of pharmacological treatment interventions ranged between US$128 and US$1,450 and up to US$4,400 per quality-adjusted life years (QALYs) saved. The use of pharmacotherapies such as varenicline, NRT, and Bupropion, when combined with GP counseling or other behavioral treatment interventions (such as proactive telephone counseling and Web-based delivery), is both clinically effective and cost effective to primary health care providers. 5. Price-based policy measures such as increase in tobacco taxes are unarguably the most effective means of reducing the consumption of tobacco. A 10$2 to US$112 per life year gained (LYG) while reducing smoking prevalence by up to 30$500 and US$614 per LYG. 7. Advertising media, telecommunications, and other technology-based interventions (such as TV, radio, print, telephone, the Internet, PC, and other electronic media) usually have positive synergistic effects in reducing smoking prevalence especially when combined to deliver smoking cessation messages and counseling support. However, the outcomes on the cost effectiveness of TMT-based measures have been inconsistent, and this made it difficult to attribute results to specific media. The differences in reported cost effectiveness may be partly attributed to varying methodological approaches including varying parametric inputs, differences in national contexts, differences in advertising campaigns tested on different media, and disparate levels of resourcing between campaigns. Due to its universal reach and low implementation costs, online campaign appears to be substantially more cost effective than other media, though it may not be as effective in reducing smoking prevalence. 8. School-based smoking prevalence programs tend to reduce short-term smoking prevalence by between 30$16,400 to US$580,000 depending on the scale and scope of intervention. The cost effectiveness of school-based programs show that one could expect a saving of approximately between US$2,000 and US$20,000 per QALY saved due to averted smoking after 2–4 years of follow-up. 9. Workplace-based interventions could represent a sound economic investment to both employers and the society at large, achieving a benefit-cost ratio of up to 8.75 and generating 12-month employer cost savings of between$150 and $540 per nonsmoking employee. Implementing smoke-free workplaces would also produce myriads of new quitters and reduce the amount of cigarette consumption, leading to cost savings in direct medical costs to primary health care providers. Workplace interventions are, however, likely to yield far greater economic benefits over the long term, as reduced prevalence will lead to a healthier and more productive workforce. CONCLUSIONS: We conclude that the direct costs and externalities to society of smoking far outweigh any benefits that might be accruable at least when considered from the perspective of socially desirable outcomes (i.e., in terms of a healthy population and a productive workforce). There are enormous differences in the application and economic measurement of smoking cessation measures across various types of interventions, methodologies, countries, economic settings, and health care systems, and these may have affected the comparability of the results of the studies reviewed. However, on the balance of probabilities, most of the cessation measures reviewed have not only proved effective but also cost effective in delivering the much desired cost savings and net gains to individuals and primary health care providers

Optimisation of a microelectronic assembly package using response surface methodology

This article addressed heat conduction in microelectronics applications. ANSYS finite element design software was used to design the model, while Design Expert software was used for the response surface methodology (RSM) analysis. The components analysed were heat-sink base (HSB) thickness, thermal interface material (TIM) thickness, and chip thickness. A design of experiment comprising of 15 central composite design (CCD) for the coded levels (low (-) and high (+)) of the factors were generated. Heat flow was applied to the chip while a convective coefficient was applied to the heat-sink. The temperature solution was used to calculate the thermal resistance response for the 15 CCD experimental runs. The results from the RSM study proposed an optimal (minimization analysis) combination of 3.5 mm, 0.04 mm, and 0.75 mm, for HSB thickness, TIM thickness, and chip thickness respectively. While the optimal mean thermal resistance of 0.31052 K/W was achieved from the proposed optimal parameters. Keywords: RSM; CCD; thermal resistance; temperature; microelectronic

Finite element analysis of the effect of fin geometry on thermal performance of heat sinks in microelectronics

Heat sinks are commonly used for the dissipation of heat in microelectronics  packages. The choice of optimal heat sinks configuration largely depends on the market demand and thermal performance. Hence, having the right heat sinks configuration is vital to the overall thermal durability of the microelectronics package. This paper investigates the thermal resistance and efficiency of heat sink fins geometry in microelectronics application. This study investigates the shapes of six (square, rectangular, triangular, hexagonal, circular, and elliptical) different heat sink fins on thermal performance. ANSYS finite element design software was used to create the 3D models and meshed between 5-20% of the initial mesh size. Transient thermal conduction analysis was used in analysing the heat sinks. The results obtained demonstrated that the more number of elements in the mesh (or the finer the mesh) the better the convergence of the numerical solution. The results also showed that the rectangular shaped heat sink fins exhibited better thermal capabilities than the other shaped fins, by having a maximum temperature of about 42.5oC, thermal resistance of about 0.244 K/W, and thermal efficiency of about 50%.Keywords: heat sink; fin geometry; thermal resistanc

Effect of Tensile Load on the Mechanical Properties of AlSiC Composite Materials using ANSYS Design Modeller

Aluminium Silicon Carbide (AlSiC) composite materials are used in the electronics industries and other manufacturing companies hence, manufacturing of AlSiC composite materials with the right properties for different applications are vital to most industries. The challenge of testing the same specimens for different properties remains, because most of the tests carried out are destructive. Hence, the use of ANSYS finite element simulation software for the design and analysis of a flat bar specimen. Loads between 3 kN to 21 kN were applied on the specimen since it is within the operating limit of a Universal Tensile Testing Machine (UTTM), while both ends are fixed. The AlSiC composite materials used in this study have a composition of 63 vol% Al (356.2) and 37 vol% SiC and, the resultsshowed that stress was directly proportional to strain. While the calculated Young’s modulus from the stress versus strain plot was approximately 167 GPa for the different tensile loads applied. In addition, the total deformation of the AlSiC composite material increased as the load was increased. Also, the highest deformation of the material was observed around the centre of the test specimen. This is synonymous with the failure observed in practical testing of specimens. Keywords: AlSiC, tensile load, aluminium MMC, stress analysis, deformation, ANSY

Effect of Fins Arrangement on Thermal Performance in Microelectronics Devices

Heat sink fins arrangement are important in heat management in microelectronics devices because it helps in the dissipation of heat from the chip level device to the environment and provide an efficiently working device. In this light, investigation was conducted on the effect of fins arrangement on thermal performance in microelectronics devices using the ANSYS finite element design software. The results obtained showed a maximum temperature range of between 95.27 – 126.79 oC, thermal resistance of 1.2 – 1.8 K/W, and thermal efficiency of 15 – 37%. The results demonstrated that, the arrangement of heat sink fins largely affects the thermal resistances and efficiencies of the microelectronic device. In addition, the A1 rectangular fins arrangement exhibited better thermal capabilities over the other fins arrangements investigated. This research can aid the development of future heat sinks to accommodate customer demands.Keywords: heat transfer; fin arrangement; microelectronic

Business lending and bank profitability in the UK

Purpose: The purpose of this paper is to investigate the importance of business lending as a source of bank profits in the UK banking system. The paper also examines whether the profitability of business lending is mostly driven by heterogeneous characteristics of individual banks or whether it is affected by systematic characteristics such as bank size and ownership structure. Design/methodology/approach: The study uses bank level data from BankScope for a total sample of 83 UK banks and building societies. The period under consideration extends from 2005 to 2009. Econometric estimation is by panel fixed effects. Findings: Our empirical results show that business lending is a statistically significant determinant of bank profits. However, this average effect masks important systematic differences among banks. In particular, we find strong size effects: the profitability of business lending is considerable for small banks but negligible for large banks. In contrast, we could not detect any ownership effects for domestic and foreign banks. These findings persist when the occurrence of the financial crisis is accounted for. Research limitations/implications: Interestingly, our study relates these findings to the process of financialisation. Yet, the extent of the latter and its impact on various groups of banks (i.e., large, small, domestic and foreign banks) have not been examined. Further research in this area would make an important contribution to the literature.. Practical implications: Our findings suggest that business lending is not a driving factor of profitability for large banks. One possible policy implication – which may be of interest especially to regulators and policy makers – is that capital injections into the larger banks per se are unlikely to lead to an expansion of credit to business. Originality/value: There is very little research in the literature on the questions addressed in this paper, especially for the UK banking system. Moreover, the process of financialisation, which motivates the enquiry of this paper, is a growing area of research. Thus, the contribution of this paper is twofold

Economic impact of smoking and of reducing smoking prevalence

Background: Tobacco smoking is the cause of many preventable diseases and premature deaths in the UK and around the world. It poses enormous health- and non-health-related costs to the affected individuals, employers, and the society at large. The World Health Organization (WHO) estimates that, globally, smoking causes over US$500 billion in economic damage each year. Objectives: This paper examines global and UK evidence on the economic impact of smoking prevalence and evaluates the effectiveness and cost effectiveness of smoking cessation measures. Study selection Search methods: We used two major health care/economic research databases, namely PubMed and the National Institute for Health Research (NIHR) database that contains the British National Health Service (NHS) Economic Evaluation Database; Cochrane Library of systematic reviews in health care and health policy; and other health-care-related bibliographic sources. We also performed hand searching of relevant articles, health reports, and white papers issued by government bodies, international health organizations, and health intervention campaign agencies. Selection criteria: The paper includes cost-effectiveness studies from medical journals, health reports, and white papers published between 1992 and July 2014, but included only eight relevant studies before 1992. Most of the papers reviewed reported outcomes on smoking prevalence, as well as the direct and indirect costs of smoking and the costs and benefits of smoking cessation interventions. We excluded papers that merely described the effectiveness of an intervention without including economic or cost considerations. We also excluded papers that combine smoking cessation with the reduction in the risk of other diseases. Data collection and analysis: The included studies were assessed against criteria indicated in the Cochrane Reviewers Handbook version 5.0.0. Outcomes assessed in the review: Primary outcomes of the selected studies are smoking prevalence, direct and indirect costs of smoking, and the costs and benefits of smoking cessation interventions (eg, “cost per quitter”, “cost per life year saved”, “cost per quality-adjusted life year gained,” “present value” or “net benefits” from smoking cessation, and “cost savings” from personal health care expenditure). Main results: The main findings of this study are as follows: 1. The costs of smoking can be classified into direct, indirect, and intangible costs. About 15$151 billion. 2.The costs of smoking notwithstanding, it produces some potential economic benefits. The economic activities generated from the production and consumption of tobacco provides economic stimulus. It also produces huge tax revenues for most governments, especially in high-income countries, as well as employment in the tobacco industry. Income from the tobacco industry accounts for up to 7.4% of centrally collected government revenue in China. Smoking also yields cost savings in pension payments from the premature death of smokers. 3. Smoking cessation measures could range from pharmacological treatment interventions to policy-based measures, community-based interventions, telecoms, media, and technology (TMT)-based interventions, school-based interventions, and workplace interventions. 4. The cost per life year saved from the use of pharmacological treatment interventions ranged between US$128 and US$1,450 and up to US$4,400 per quality-adjusted life years (QALYs) saved. The use of pharmacotherapies such as varenicline, NRT, and Bupropion, when combined with GP counseling or other behavioral treatment interventions (such as proactive telephone counseling and Web-based delivery), is both clinically effective and cost effective to primary health care providers. 5. Price-based policy measures such as increase in tobacco taxes are unarguably the most effective means of reducing the consumption of tobacco. A 10$2 to US$112 per life year gained (LYG) while reducing smoking prevalence by up to 30 6. Smoking cessation classes are known to be most effective among community-based measures, as they could lead to a quit rate of up to 35$500 and US$614 per LYG. 7. Advertising media, telecommunications, and other technology-based interventions (such as TV, radio, print, telephone, the Internet, PC, and other electronic media) usually have positive synergistic effects in reducing smoking prevalence especially when combined to deliver smoking cessation messages and counseling support. However, the outcomes on the cost effectiveness of TMT-based measures have been inconsistent, and this made it difficult to attribute results to specific media. The differences in reported cost effectiveness may be partly attributed to varying methodological approaches including varying parametric inputs, differences in national contexts, differences in advertising campaigns tested on different media, and disparate levels of resourcing between campaigns. Due to its universal reach and low implementation costs, online campaign appears to be substantially more cost effective than other media, though it may not be as effective in reducing smoking prevalence. 8. School-based smoking prevalence programs tend to reduce short-term smoking prevalence by between 30$16,400 to US$580,000 depending on the scale and scope of intervention. The cost effectiveness of school-based programs show that one could expect a saving of approximately between US$2,000 and US$20,000 per QALY saved due to averted smoking after 2–4 years of follow-up. 9. Workplace-based interventions could represent a sound economic investment to both employers and the society at large, achieving a benefit–cost ratio of up to 8.75 and generating 12-month employer cost savings of between$150 and $540 per nonsmoking employee. Implementing smoke-free workplaces would also produce myriads of new quitters and reduce the amount of cigarette consumption, leading to cost savings in direct medical costs to primary health care providers. Workplace interventions are, however, likely to yield far greater economic benefits over the long term, as reduced prevalence will lead to a healthier and more productive workforce. Conclusions: We conclude that the direct costs and externalities to society of smoking far outweigh any benefits that might be accruable at least when considered from the perspective of socially desirable outcomes (ie, in terms of a healthy population and a productive workforce). There are enormous differences in the application and economic measurement of smoking cessation measures across various types of interventions, methodologies, countries, economic settings, and health care systems, and these may have affected the comparability of the results of the studies reviewed. However, on the balance of probabilities, most of the cessation measures reviewed have not only proved effective but also cost effective in delivering the much desired cost savings and net gains to individuals and primary health care providers

Analysis of Socio-Political Implication of Infrastructural Decay in Nigeria

The aim of this paper is to critically analyze the decay in infrastructural facilities in Nigeria. The state of infrastructures and its decay in Nigeria has remained a matter of great concern arising from the fact that infrastructural functionality plays a pivotal role in the socio-economic well being of the populace and the overall growth and development process of the economy. There is no gain saying the fact that adequacy of functional infrastructure is necessary for a growing economy like that of Nigeria. The state of this decay has become so bad that analysis carried on the ratio of „functional infrastructure‟ to the need for it by both the individual and the corporate bodies revealed that it is grossly inadequate. The analysis further reveals that over ninety percent of the corporate institutions and over forty percent of individual now resort to meeting their own infrastructural needs than to depend on the government to provide these basic needs to the generality of the populace. In the light of the aforementioned, this study on the „socio economic implication of infrastructural decay in Nigeria‟ focused attention more on trying to critically appraise the effectiveness of infrastructural facilities in the nation, providing an insight into how weak the various organs of the federal and the state governments are in terms of provision of infrastructures in Nigeria. This study further aimed at reviewing the reasons for the under-funding and failure of the federal government to address the systemic problems and corruption in the Nation that led to a significant infrastructural deficit. This study is divided into several sessions for ease of understanding of the subject matter with a view to succinctly dealing with the issues. Conclusion was drawn based on the findings with few recommendations.Keywords: Nigeria, Decay, Network, Money, Corruption, Infrastructur

Powers of the Executive and Legislature in Budget Making Process in Nigeria: An Overview

Friction between the executive and legislative arms of the government is a common phenomenon in modern democracies the world over. Because of its attendant consequences, the budget process is often a cause of significant friction between the legislature and executive arms. In Nigeria, the issue that calls for determination has been the extent of powers of the legislature in matters of budget formulation and approval. For years, this dispute has remained unabated and none of the parties has summoned the courage to approach the courts for its interpretation. This controversy, once again, has been in the front burner, resulting in inordinate delay in the passage of the 2016 nation’s Budget. The executive arm of the government is vehement in objecting to any amendments, modifications and alterations made to the annual budgetary estimates prepared by the executive and placed before the National Assembly as it affects various ministries and government departments. In other words, it is their take that the function of the legislative arm is simply to ‘rubber stamp’ the budget estimates. Politicians, legislators and lawyers are divided on this issue. This paper examines the powers and functions of both arms of government but more especially the legislature on Appropriation Bills. We examined a critical aspect of the controversy that surrounded the delay in the passage of the 2016 Budget because of the importance it has for future budgetary processes. We argue in this article that in the interest of allowing inputs of trade unions, NGOs and other stakeholders through the opportunities provided by Public Hearings, it is in the larger public interest to sustain the operation of the current legal framework which supports, in our humble opinion, the power of the National Assembly to alter the budgetary estimates submitted by the executive, either marginally or fundamentally, as the National Assembly may deem fit.  We support our argument with an overview of international practices, which vary, depending only on constitutional or legal provisions in individual countries. A brief discussion on the relationship which exists in both arms of government, the causes and effect of frictions between them are also considered. Keywords: conflicts, executive arm, legislative arm, powers, budgetary estimates, appropriation bills