OBJECTIVES : In Indonesia, tobacco smoking is a major public health problem that continues to grow, with a prevalence that is among the highest in the world. To assess the cost-effectiveness of government-funded varenicline, smoking bans in public places and an additional 10% tobacco tax in Indonesia.

METHODS : Markov modelling of Indonesians aged 15 to 80 years was undertaken, with simulated follow up until age 85 years. Data on demographics, the prevalence of smoking and mortality were drawn from the Global Burden of Disease Study 2017. Data regarding efficacy and costs of the three interventions were gathered from published sources. Costs and benefits accrued beyond one year were discounted at a 3% per annum.

RESULTS : Government-funded varenicline, smoking bans in public places and an additional 10% tobacco tax were predicted to save 5.5 million, 1.6 million and 1.7 million years of life, respectively (all discounted). From the perspective of the healthcare system, all three interventions were cost-saving. Outside of the healthcare system, government-funded varenicline, smoking bans in public places and an additional 10% tobacco tax were predicted to also save 1.7 million, 514,778 and 560,199 productivity-adjusted life years (PALYs), respectively, equating to USD $21 billion, $6.0 billion and $6.5 billion gains in gross domestic product.

CONCLUSIONS : In Indonesia, tobacco control measures are all likely to be highly cost-effective, and even cost-saving from the perspective of the healthcare system. These cost savings can be balanced against economic losses that would result from the impact on the large Indonesian tobacco industry.