Effects of water re-allocation in the Ebro river basin: A multiregional input-output and geographical analysis

The quality and availability of water are affected by numerous variables, through which the evaluation of water uses from different perspectives, and policy proposals to save water have now become essential. This paper aims to study water use and the water footprint from a river basin perspective, taking into account regions, sectors, and municipalities, while considering the physical frontier along with the administrative sectors. To this end, we have constructed a multi-regional input-output table for the Ebro river basin, disaggregating the primary sector into 18 different crops and 6 livestock groups. We pay special attention to crop production because it is the most water-consuming industry. The construction of the multi-regional input-output model represents an important contribution to the literature, in itself, since, to the best of our knowledge, it is the first to be built for this large basin. We extend this multi-regional input-output model to assess the water footprint by sectors and regions within the basin. We use these data to propose two scenarios: reallocating final demand to reduce the blue water footprint (scenario 1), and increasing value added (scenario 2). These scenarios outline the opportunity costs of saving water in socioeconomic terms in the basin. In another application, we downscale the multi-regional input-output model results at the municipal level and depict them using a geographical information system, identifying the hotspots and the areas that would pay for the socioeconomic opportunity costs of saving water. Our results suggest that saving 1 hm 3 of blue water could cost around €41, 500 of value added if we consider the entire basin. However, this water re-allocation implies losses and gains at the municipal level: some municipalities would reduce value added by more than €30, 000, while others would gain more than €85, 000 of value added. These tools and results can be useful for policy makers when considering re-allocating water. The contribution and the novelty of this paper is the construction of the multiregional input-output model for the Ebro river basin, and its link with geographical systems analysis at the municipal level

Cost-effectiveness of alternative smoking cessation scenarios in Spain: results from the EQUIPTMOD

Aims: To assess the cost-effectiveness of alternative smoking cessation scenarios from the perspective of the Spanish National Health Service (NHS). Design: We used the EQUIPTMOD, a Markov-based state transition economic model, to estimate the return on investment (ROI) of: (a) the current provision of smoking cessation services (brief physician advice and printed self-helped material + smoking ban and tobacco duty at current levels); and (b) four alternative scenarios to complement the current provision: coverage of proactive phone calls; nicotine replacement therapy (mono and combo) (Rx NRT); varenicline (standard duration); or bupropion. A rate of 3% was used to discount lifetime costs and benefits. Setting: Spain. Participants: Adult smoking population (16+ years). Measurements: Healthcare costs associated with treatment of smoking attributable diseases (lung cancer, coronary heart disease, chronic obstructive pulmonary infection and stroke); intervention costs; quality-adjusted life years (QALYs). Costs and outcomes were summarized using various ROI estimates. Findings: The cost of implementing the current provision of smoking cessation services is about €61million in the current year. This translates to 18 quitters per 1000 smokers and a lifetime benefit-cost ratio of 5, compared with no such provision. All alternative scenarios were dominant (cost-saving: less expensive to run and generated more QALYs) from the lifetime perspective, compared with the current provision. The lifetime benefit-cost ratios were: 1.87 (proactive phone calls); 1.17 (Rx NRT); 2.40 (varenicline-standard duration); and bupropion (2.18). The results remained robust in the sensitivity analysis. Conclusions: According to the EQUIPTMOD modelling tool it would be cost-effective for the Spanish authorities to expand the reach of existing GP brief interventions for smoking cessation, provide pro-active telephone support, and reimburse smoking cessation medication to smokers trying to stop. Such policies would more than pay for themselves in the long run.EU 7th Framewor