Jindal S K, Sapru R P, Aggarwal A N, Chaudhry K
Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India.
Natl Med J India. 2005 May-Jun;18(3):123-6.
There is paucity of information on health-related expenditure attributed to smoking in India. This community study estimated the expenditure on healthcare and morbidity borne by families of smokers and compared these with those of families without smokers. It was hypothesized that families with smokers were likely to have a higher health expenditure than non-smoker families attributable to the increased probability of health problems associated with smoking.
The study population comprised 1000 urban and rural families divided into two groups. Group I consisted of 500 families with one or more smoker(s) while group II comprised 500 families without a smoker. Both groups had an equal representation from the urban and rural populations (250 each). The study team used a structured, generally close-ended questionnaire, pre-tested for its validity and reliability, to interview the families. Different components of health-related expenditure and other morbidity indices were studied. Each family was studied in two phases: (i) initially, for the retrospective assessment of expenditure and other losses during the preceding one year, and (ii) prospectively, for the following 10 months on repeated visits and estimations made every two months. The data collected retrospectively were mostly incomplete and could not be used for analyses.
The number of family members reporting sick was significantly higher in group I than in group II among both urban and rural families (p < 0.001). There was an excess expenditure of Rs 730 and Rs 141, in addition to Rs 4209 and Rs 894 on smoking products in group I families in urban and rural areas, respectively. Univariate analysis showed that the odds ratio for having any health-related expenditure for a group I family was 3.346 (95% confidence interval 2.533-4.420), which was highly significant (p < 0.0001). The differences in loss of work on account of illness and loss of man-days among members of groups I and II were not significant. However, the number of lost school days among children of group I families, loss of efficiency of its members and change of jobs due to loss of efficiency were highly significant.
The direct healthcare costs as well as the indirect fiscal losses are higher in families with one or more smoker(s).
在印度，关于吸烟导致的与健康相关支出的信息匮乏。这项社区研究估算了吸烟者家庭的医疗保健支出和发病率，并将其与无吸烟者家庭的情况进行比较。研究假设，由于吸烟相关健康问题的可能性增加，有吸烟者的家庭可能比无吸烟者家庭有更高的医疗支出。
研究人群包括1000个城乡家庭，分为两组。第一组由500个有一名或多名吸烟者的家庭组成，而第二组由500个无吸烟者的家庭组成。两组在城乡人口中各占相同比例（各250个）。研究团队使用一份经过效度和信度预测试的结构化、通常为封闭式的问卷对家庭进行访谈。研究了与健康相关支出的不同组成部分和其他发病率指标。每个家庭分两个阶段进行研究：（i）最初，用于回顾性评估前一年的支出和其他损失；（ii）前瞻性地，在接下来的10个月里，通过每两个月进行一次重复访问和估算。回顾性收集的数据大多不完整，无法用于分析。
在城乡家庭中，第一组报告患病的家庭成员数量均显著高于第二组（p < 0.001）。在城市和农村地区，第一组家庭除了分别在吸烟产品上花费4209卢比和894卢比外，还分别额外支出730卢比和141卢比。单因素分析显示，第一组家庭发生任何与健康相关支出的比值比为3.346（95%置信区间2.533 - 4.420），具有高度显著性（p < 0.0001）。第一组和第二组家庭成员因病误工天数和工作日损失的差异不显著。然而，第一组家庭儿童的缺课天数、其成员的效率损失以及因效率损失导致的工作变动情况具有高度显著性。
有一名或多名吸烟者的家庭的直接医疗成本以及间接财政损失更高。
