Centre for Public Policy Research, Kochi, Kerala, India.
Tob Control. 2019 Sep;28(5):513-518. doi: 10.1136/tobaccocontrol-2018-054493. Epub 2018 Oct 18.
To estimate the economic burden of diseases and deaths attributable to bidi smoking in India for persons aged 30-69 years.
The National Sample Survey data on healthcare expenditures, data on bidi smoking prevalence from the Global Adult Tobacco Survey and relative risks of all-cause mortality from bidi smoking are used to estimate the economic burden of diseases and deaths attributable to bidi smoking in India using a prevalence-based attributable-risk approach. Costs are estimated under the following heads: (1) direct medical expenditure of treating diseases; (2) indirect morbidity costs and (3) indirect mortality costs of premature deaths.
The total economic costs attributable to bidi smoking from all diseases and deaths in India in the year 2017 for persons aged 30-69 years amount to INR805.5 billion (US$12.4 billion), of which 20.9% is direct and 79.1% is indirect cost. Men bear 93.7% of the total costs.
The total annual economic costs of bidi smoking amount to approximately 0.5% of India's gross domestic product, while the excise tax revenue from bidi is only half a per cent of its economic costs. The direct medical costs of bidi smoking amount to 2.24% of total health expenditure. Since the poor bear a disproportionately large share of the economic costs of bidi smoking, the unregulated use of bidi would potentially push more households in India, which incur heavy out-of-pocket expenditures on healthcare, into poverty.
估计印度 30-69 岁人群归因于比迪烟消费的疾病和死亡的经济负担。
本研究使用基于患病率的归因风险方法，利用国家抽样调查中的医疗支出数据、全球成人烟草调查中的比迪烟流行率数据以及比迪烟导致全因死亡率的相对风险，来估计归因于比迪烟消费的疾病和死亡导致的印度经济负担。费用估计包括以下方面：（1）治疗疾病的直接医疗支出；（2）发病率间接成本；（3）早逝的死亡率间接成本。
2017 年，印度 30-69 岁人群归因于所有疾病和死亡的比迪烟总经济成本达 8055 亿印度卢比（合 124 亿美元），其中 20.9%为直接成本，79.1%为间接成本。男性承担了总成本的 93.7%。
比迪烟的年总经济成本约占印度国内生产总值的 0.5%，而比迪烟的消费税仅占其经济成本的一半。比迪烟的直接医疗成本占总卫生支出的 2.24%。由于穷人承担了比迪烟经济成本的不成比例的大部分，因此比迪烟的无管制使用可能会使印度更多的家庭陷入贫困，这些家庭在医疗保健方面支出了大量的自付费用。
