Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
George & Fay Yee Centre for Healthcare Innovation, University of Manitoba, Winnipeg, Manitoba, Canada.
Can J Public Health. 2019 Oct;110(5):533-541. doi: 10.17269/s41997-019-00244-x. Epub 2019 Sep 6.
The objectives of this study were to: (1) examine whether the smoking status of the Canadian population is associated with a reduction in health-related quality of life (HRQoL); (2) calculate the overall economic burden of loss in HRQoL using a commonly accepted $100,000 willingness-to-pay (WTP) threshold to gain one quality-adjusted life year (QALY); and (3) calculate the loss of HRQoL over a lifetime.
We used the 2015 Canadian Community Health Survey. The variations in HRQoL were estimated using a multivariable generalized linear model. Total expected lifetime QALYs lost due to smoking were calculated by compounding the annual adjusted health utility loss associated with smoking across a respondent's remaining years of life expectancy stratified by age. A discount rate of 1.5% was applied to the analysis based on recent analysis of the costs of borrowing in Canada.
Smoking is significantly associated with HRQoL loss. This study demonstrated that smoking is associated with a 0.05 and 0.01 reduction in Health Utilities Index Mark 3 (HUI3) score for current and former smokers, which also corresponds to a loss of 0.66 quality-adjusted life years in average, and also is associated with substantial individual and societal economic cost. The total lifetime economic burden of HUI3 loss per smoker was $65,935, yielding in the aggregate a societal burden of $1068.88 billion in the study population.
Tobacco control, prevention and intervention not only will improve HRQoL but also will generate social returns on investment.
本研究旨在：（1）检验加拿大人口的吸烟状况是否与健康相关生活质量（HRQoL）的下降有关；（2）使用普遍接受的 10 万美元支付意愿（WTP）阈值来获得一个质量调整生命年（QALY），计算因丧失 HRQoL 而产生的总体经济负担；（3）计算终生丧失的 HRQoL。
我们使用了 2015 年加拿大社区健康调查。使用多变量广义线性模型来估计 HRQoL 的变化。通过将与吸烟相关的每年调整后健康效用损失复合在受访者剩余预期寿命内，计算因吸烟而导致的终生预期 QALY 损失，根据最近对加拿大借款成本的分析，采用 1.5%的贴现率进行分析。
吸烟与 HRQoL 损失显著相关。本研究表明，吸烟与当前和以前吸烟者的健康效用指数标记 3（HUI3）评分分别降低 0.05 和 0.01 相关，这也相当于平均丧失 0.66 个质量调整生命年，并且还与个人和社会的巨大经济成本相关。每位吸烟者终生 HUI3 损失的总经济负担为 65935 美元，研究人群的总社会负担为 10688.88 亿美元。
烟草控制、预防和干预不仅会提高 HRQoL，还会产生投资的社会回报。
