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How much do smokers cost to the health system?

February 21, 2019

The economic cost of smoking have been quantified mainly in high-income countries, while the numbers are not clear in developing countries - where the epidemic is more advanced - . That is why the authors of "Global economic cost of smoking-attributable diseases" (Goodchild et al, 2018) aimed to calculate the cost on the health system of diseases attributable to smoking around the world.

The authors clarify that one of the limitations of the study is that the cost associated with second-hand smoke and smokeless forms of tobacco is not calculated. Considering that the damages of secondhand smoke are quite high and that forms of smokeless tobacco are very popular in certain countries, it is necessary to take note of the underestimation inherent to the obtained figure. However, the estimates it provides are an input for countries to recognize the seriousness of this issue.

The study collects data from 152 countries with 97% representation of global smokers. The results are presented with the purchasing power parity (PPP) rate of 2012 to ensure that comparisons can be made between countries. The results are alarming: health expenditures for these diseases total (PPP) $ 467 billion or (USD) $ 422 in 2012. The former is equivalent to 5.7% of total health spending in the world.

In conclusion, smoking places a heavy burden on the health budget and, this is even worse, countries where the epidemic is more advanced. Therefore, this study reiterates the need for national governments to implement -if they have not done so- or increase -if it is lagged- the tobacco tax. By being the most effective measure to reduce consumption, tobacco taxes should be a priority on the health policy agendas worldwide; With this measure, governments will be able to free a large part of the national budget that is destined to cover the health expenses caused by this epidemic.

Governments should not wait until the problem expands to take action. It must be borne in mind that these diseases (and the costs they entail) are largely preventable. In developing countries, it becomes an opportunity to redirect the budget towards other public health programs that respond to the particular urgencies of their regions.