Introduction:
The aim of this study is to quantify the cost-effectiveness of four tobacco control interventions: tobacco taxation, mass media campaigns, school programs, and cessation support, and illustrate how available evaluation tools can be adapted to the local setting.

Material and Methods:
The dynamic population health modeling (DYNAMO-HIA) tool was used to project the future smoking prevalence associated with the interventions and to simulate the resulting smoking-related disease burden over time. Applying the most recently available national Mongolian data as input, costs and effects of four interventions were compared to a business as usual scenario, resulting in costs per life year gained, and per disability adjusted life years (DALYs) averted.

Results:
Over three years after implementation, all interventions reduce the prevalence of current smoking, with the largest reduction observed from the tobacco tax increase (5.1% points), followed by mass media campaigns (1.6% points), school programs (1.3% points) and cessation support interventions (0.6% points). School programs were a cost-saving tobacco control intervention when compared to current practice in Mongolia, while the other programs resulted in additional costs compared to business as usual. Compared to the WHO thresholds, all interventions would be considered “very cost-effective” in terms of cost per DALY averted (below US$ 4295 per DALY averted) in Mongolia.

Conclusions:
Large-scale interventions such as taxation and mass media bring both a favorable cost-effectiveness and large health benefits in relation to their intervention costs. Reducing the prevalence of current smoking among the male population would be particularly worthwhile in Mongolia.