McGhee S M, Ho L M, Lapsley H M, Chau J, Cheung W L, Ho S Y, Pow M, Lam T H, Hedley A J
Department of Community Medicine, University of Hong Kong, Hong Kong SAR, China.
Tob Control. 2006 Apr;15(2):125-30. doi: 10.1136/tc.2005.013292.
Costs of tobacco-related disease can be useful evidence to support tobacco control. In Hong Kong we now have locally derived data on the risks of smoking, including passive smoking.
To estimate the health-related costs of tobacco from both active and passive smoking.
Using local data, we estimated active and passive smoking-attributable mortality, hospital admissions, outpatient, emergency and general practitioner visits for adults and children, use of nursing homes and domestic help, time lost from work due to illness and premature mortality in the productive years. Morbidity risk data were used where possible but otherwise estimates based on mortality risks were used. Utilisation was valued at unit costs or from survey data. Work time lost was valued at the median wage and an additional costing included a value of USD 1.3 million for a life lost.
In the Hong Kong population of 6.5 million in 1998, the annual value of direct medical costs, long term care and productivity loss was USD 532 million for active smoking and USD 156 million for passive smoking; passive smoking accounted for 23% of the total costs. Adding the value of attributable lives lost brought the annual cost to USD 9.4 billion.
The health costs of tobacco use are high and represent a net loss to society. Passive smoking increases these costs by at least a quarter. This quantification of the costs of tobacco provides strong motivation for legislative action on smoke-free areas in the Asia Pacific Region and elsewhere.
与烟草相关疾病的成本可作为支持控烟的有用证据。在香港，我们现在已有本地得出的吸烟风险数据，包括被动吸烟风险数据。
估算主动吸烟和被动吸烟对健康造成的成本。
利用本地数据，我们估算了主动吸烟和被动吸烟导致的成人及儿童死亡率、住院率、门诊就诊率、急诊就诊率和全科医生就诊率，以及养老院和家政服务的使用情况、因病误工时间和生产期过早死亡情况。在可能的情况下使用发病风险数据，否则则使用基于死亡风险的估算值。利用单位成本或调查数据对利用率进行估值。误工时间按中位数工资估值，另外还包括每例死亡130万美元的成本估算。
在1998年香港650万人口中，主动吸烟导致的直接医疗成本、长期护理和生产力损失的年度价值为5.32亿美元，被动吸烟为1.56亿美元；被动吸烟占总成本的23%。加上归因死亡的价值，年度成本达到94亿美元。
烟草使用的健康成本很高，是社会的净损失。被动吸烟使这些成本至少增加了四分之一。对烟草成本的这种量化为亚太地区及其他地区关于无烟区的立法行动提供了强大动力。
