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The European Journal of Public Health Advance Access published online on November 11, 2008
The European Journal of Public Health, doi:10.1093/eurpub/ckn103
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© The Author 2008. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Potential population impact of changes in heroin treatment and smoking prevalence rates: using Population Impact Measures

Perihan Torun1, Richard F. Heller2 and Arpana Verma1

1 Clinical Epidemiology and Public Health Unit, Stopford Building University of Manchester, Manchester M13 9PT, UK.
2 Evidence for Population Health Unit, Stopford Building University of Manchester, Manchester M13 9PT, UK.

Correspondence: Dr Perihan Torun, Room 2.808, Clinical Epidemiology and Public Health Unit, Stopford Building University of Manchester, Manchester M13 9PT, UK. tel.: +44 161 275 5472, fax: + 44 161 275 7712, e-mail: perihan.torun{at}manchester.ac.uk

Received April 10, 2008 , accepted September 29, 2008

Background: The drug misuse and asthma are major health problems in urban settings. There are effective interventions to reduce cigarette smoking and also to treat heroin use; in the context of European System of Urban Health Indicators Project (EURO-URHIS), we explored the use of Population Impact Measures (PIMs) to describe the potential for increase in methadone use and reduction in cigarette smoking to reduce deaths -from heroin use- and asthma events in examples of urban populations. Methods: The two PIMs calculated here are the Number of Events Prevented in your Population (NEPP) and the Population Impact Number of Eliminating (or reducing the prevalence of) a Risk Factor (PIN-ER-t). Results: Increasing methadone treatment uptake from its current levels to 90% would prevent 21 (95% CI: 11–34) deaths in Manchester City, 218 (95% CI: 114–339) in Greater London and overall 1 243 (95% CI: 641–1953) in England in 1 year. In males 2 (95% CI: –22 to 28), 27 (95% CI: –296 to 363) and 170 (95% CI: –1757 to 2186) and in females 36 (95% CI: 6–70), 0 and 2312 (95% CI: 934–3783) fewer asthma cases per year would have been expected in Manchester City, Greater London and overall in England respectively, if the smoking prevalence is reduced from current levels to 20% in both sexes. Conclusions: PIMs provide estimates of absolute risk and benefit to a total population, of potential use to policy-makers since current practice and intervention goals are taken into account.

Keywords: asthma, impact of interventions, population impact measures, substance use


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