Ministry of Health, Nutrition and Indigenous Medicine, Institute of Oral Health, Maharagama, Sri Lanka.
Sri Lanka Medical Association, Colombo, Sri Lanka.
Tob Control. 2018 Sep;27(5):542-546. doi: 10.1136/tobaccocontrol-2017-053791. Epub 2017 Oct 27.
Cancer has a high mortality rate and morbidity burden in Sri Lanka. This study estimated the economic cost of smoking and smokeless tobacco (ST) related to cancers in Sri Lanka in 2015.
Prevalence-based cost of illness is calculated according to the guidelines of the WHO (2011). The direct costs are costs of curative care (costs of inward patients and outpatient care borne by the state and out of pocket expenditure by households) for tobacco-related cancers, weighted by the attributable fractions for these cancers. Indirect costs are lost earnings due to mortality and morbidity (absenteeism of both patient and carers resulting from seeking care and recuperation).Data were obtained from the Registrar General's Department, National Cancer Registry, Department of Census and Statistics and the Central Bank of Sri Lanka. Household and systemic costs and relative risks were extracted from research studies. Oncologists (working in both public and private sectors), other clinical specialists, medical administrators and economists were consulted during the estimation and validation processes.
The total economic cost of tobacco-related cancers for Sri Lanka in 2015 was estimated to be US$121.2 million. The direct cost of smoking and ST-related cancers was US$42.1 million, which was 35% of the total cost, while the indirect cost was US$79.1 million, which was 65% of the total cost.
Burden of tobacco smoking and ST-related cancers as reflected in these economic costs is enormous: affecting the healthcare system and country's economy. Policymakers should take note of this burden and address tobacco consumption control as a priority.
癌症在斯里兰卡的死亡率和发病负担很高。本研究估计了 2015 年与吸烟和无烟烟草（ST）相关的癌症给斯里兰卡造成的经济成本。
根据世界卫生组织（2011 年）的指南，计算了基于患病率的疾病成本。直接成本是与烟草相关癌症的治疗性护理费用（国家承担的住院患者和门诊护理费用以及家庭自费支出），按这些癌症的归因分数加权。间接成本是由于死亡和发病造成的收入损失（患者和护理人员因寻求护理和康复而缺勤）。数据来自登记总干事办公室、国家癌症登记处、人口普查和统计局以及斯里兰卡中央银行。家庭和系统成本和相对风险从研究中提取。在估计和验证过程中，咨询了肿瘤学家（在公共和私营部门工作）、其他临床专家、医疗管理人员和经济学家。
2015 年，斯里兰卡与烟草相关的癌症的总经济成本估计为 1.212 亿美元。吸烟和 ST 相关癌症的直接成本为 4210 万美元，占总成本的 35%，而间接成本为 7910 万美元，占总成本的 65%。
这些经济成本反映出，烟草使用和 ST 相关癌症的负担巨大：影响医疗保健系统和国家经济。决策者应注意到这一负担，并将控制烟草消费作为优先事项。
