Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil.
Instituto de Efectividad Clínica y Sanitaria, Buenos Aires, Argentina.
Cad Saude Publica. 2019 Aug 29;35(8):e00129118. doi: 10.1590/0102-311X00129118.
The prevalence of smoking in Brazil has decreased considerably in recent decades, but the country still has a high burden of disease associated with this risk factor. The study aimed to estimate the burden of mortality, morbidity, and costs for society associated with smoking in 2015 and the potential impact on health outcomes and the economy based on price increases for cigarettes through taxes. Two models were developed: the first is a mathematical model based on a probabilistic microsimulation of thousands of individuals using hypothetical cohorts that considered the natural history, costs, and quality of life of these individuals. The second is a tax model applied to estimate the economic benefit and health outcomes in different price increase scenarios in 10 years. Smoking was responsible for 156,337 deaths, 4.2 million years of potential life lost, 229,071 acute myocardial infarctions, 59,509 strokes, and 77,500 cancer diagnoses. The total cost was BRL 56.9 billion (USD 14.7 billion), with 70% corresponding to the direct cost associated with healthcare and the rest to indirect cost due to lost productivity from premature death and disability. A 50% increase in cigarette prices would avoid 136,482 deaths, 507,451 cases of cardiovascular diseases, 64,382 cases of cancer, and 100,365 cases of stroke. The estimated economic benefit would be BRL 97.9 billion (USD 25.5 billion). In conclusion, the burden of disease and economic losses associated with smoking is high in Brazil, and tax increases are capable of averting deaths, illness, and costs to society.
巴西的吸烟率在最近几十年已经大幅下降，但该国仍然面临着与这一风险因素相关的高疾病负担。本研究旨在评估 2015 年吸烟对死亡率、发病率和社会成本的负担，以及基于税收提高香烟价格对健康结果和经济的潜在影响。开发了两种模型：第一种是基于对数千名个体进行概率微模拟的数学模型，使用考虑这些个体的自然史、成本和生活质量的假设队列。第二种是一种税收模型，用于估计在 10 年内不同价格上涨情景下的经济效益和健康结果。吸烟导致 156337 人死亡，420 万人失去潜在寿命，229071 例急性心肌梗死，59509 例中风和 77500 例癌症诊断。总费用为 569 亿雷亚尔（147 亿美元），其中 70%与医疗保健直接相关，其余部分与过早死亡和残疾导致的生产力损失的间接成本有关。香烟价格上涨 50%将避免 136482 人死亡，507451 例心血管疾病，64382 例癌症和 100365 例中风。估计的经济效益将达到 979 亿雷亚尔（255 亿美元）。总之，吸烟给巴西带来的疾病负担和经济损失很高，增加税收能够避免死亡、疾病和社会成本。
