Bolin Kristian, Lindgren Björn
Department of Health Sciences, Lund University, Lund University Centre for Health Economics (LUCHE), Vårdal Institute, Sweden.
Scand J Public Health. 2007;35(2):187-96. doi: 10.1080/14034940600858557.
Objectives were (a) to estimate healthcare cost and productivity losses due to smoking in Sweden 2001 and (b) to compare the results with studies for Sweden 1980, Canada 1991, Germany 1996, and the USA 1998.
Published estimates on relative risks and Swedish smoking patterns were used to calculate attributable risks for smokers and former smokers. These were applied to cost estimates for smoking-related diseases based on data from public Swedish registers.
The estimated total cost for Sweden 2001 was US 804 million dollars; COPD and cancer of the lung accounted for 43%. Healthcare cost accounted for 26% of the total cost. The estimated costs per smoker were US 3,200 dollars in the USA 1998; 1,600 in Canada 1991; 1,100 in Germany 1996; 600 in Sweden 2001; and 300 in Sweden 1980 (all in 2001 US dollar prices).
To reduce the prevalence of smoking is an issue worthwhile pursuing in its own right. In order to reduce the cost of smoking, however, policy-makers should also explore and influence the factors that determine the cost per smoker. Sweden seems to have been more successful than comparable countries in pursuing both these objectives.
目标如下:(a)估算2001年瑞典因吸烟导致的医疗成本和生产力损失;(b)将结果与瑞典1980年、加拿大1991年、德国1996年及美国1998年的研究结果进行比较。
利用已发表的相对风险估算值和瑞典吸烟模式来计算吸烟者和既往吸烟者的归因风险。这些归因风险应用于基于瑞典公共登记数据的吸烟相关疾病成本估算。
2001年瑞典的估算总成本为8.04亿美元;慢性阻塞性肺疾病(COPD)和肺癌占43%。医疗成本占总成本的26%。1998年美国每位吸烟者的估算成本为3200美元;1991年加拿大为1600美元;1996年德国为1100美元;2001年瑞典为600美元;1980年瑞典为300美元(均按2001年美元价格计算)。
降低吸烟率本身就是一个值得追求的问题。然而,为了降低吸烟成本,政策制定者还应探索并影响决定每位吸烟者成本的因素。瑞典在实现这两个目标方面似乎比可比国家更为成功。