Health Economist and Independent Researcher, Kerala, India.
World Health Organization India Country Office, New Delhi, India.
Nicotine Tob Res. 2021 Jan 22;23(2):294-301. doi: 10.1093/ntr/ntaa154.
About 28.6% of Indian adults use tobacco. This study estimates the economic burden of deaths and diseases attributable to smoking and smokeless tobacco (SLT) use for persons aged ≥35 years.
The National Sample Survey data on healthcare expenditures, the Global Adult Tobacco Survey data on tobacco use prevalence, and relative risks of all-cause mortality from tobacco use were used to estimate the economic burden of diseases and deaths attributable to tobacco use in India, using a prevalence-based attributable-risk approach. Costs are estimated under the following heads: (1) direct medical and nonmedical expenditures; (2) indirect morbidity costs; and (3) indirect mortality costs of premature deaths.
Total economic costs attributable to tobacco use from all diseases and deaths in India in the year 2017-2018 for persons 35 years or older amount to INR 1773.4 billion (US $27.5 billion), of which 22% is direct and 78% is indirect cost. Men bear 91% of the total costs. Smoking contributed 74% and SLT use contributed 26% of the costs.
The economic costs of tobacco use amount to approximately 1.04% of India's gross domestic product (GDP), while the excise tax revenue from tobacco in the previous year was only 12.2% of its economic costs. The direct medical costs alone amount to 5.3% of total health expenditure. The enormous costs imposed on the nation's health care system due to tobacco use could potentially stress the public health care system and strain the economy and it warrants massive scaling up of tobacco control efforts in India.
The study finds that the economic burden from tobacco constitutes more than 1% of India's GDP, and the direct health expenditures on treating tobacco-related diseases alone accounts for 5.3% of the total private and public health expenditures in India in a year. It shows that, for every INR 100 that is received as excise taxes from tobacco products, INR 816 of costs is imposed on society through its consumption. It establishes that tobacco consumption is a major resource drain on the national exchequer, and its effective regulation through comprehensive fiscal and non-fiscal policies is highly warranted.
约 28.6%的印度成年人使用烟草。本研究估算了归因于吸烟和无烟烟草（SLT）使用的≥35 岁人群的死亡和疾病的经济负担。
使用国家抽样调查数据中关于医疗保健支出的信息、全球成人烟草调查数据中关于烟草使用流行率的信息，以及与吸烟相关的全因死亡率的相对风险，采用基于患病率的归因风险方法，估算了印度归因于烟草使用的疾病和死亡的经济负担。成本估算分为以下几类：（1）直接医疗和非医疗支出；（2）间接发病成本；（3）过早死亡的间接死亡成本。
2017-2018 年，归因于印度 35 岁及以上人群所有疾病和死亡的烟草使用总经济成本为 17734 亿印度卢比（275 亿美元），其中 22%为直接成本，78%为间接成本。男性承担了总成本的 91%。吸烟导致了 74%的费用，而无烟烟草使用导致了 26%的费用。
烟草使用的经济成本约占印度国内生产总值（GDP）的 1.04%，而前一年的烟草消费税收入仅为其经济成本的 12.2%。仅直接医疗成本就占总卫生支出的 5.3%。由于烟草使用给国家卫生保健系统造成的巨大成本，可能会给公共卫生保健系统带来压力，给经济带来压力，这就需要在印度大规模加强烟草控制工作。
研究发现，烟草造成的经济负担超过了印度 GDP 的 1%，仅一年中用于治疗与烟草相关疾病的直接健康支出就占印度私人和公共卫生总支出的 5.3%。这表明，从烟草产品中每获得 100 卢比的消费税，社会就要为此承担 816 卢比的成本。这表明，烟草消费是国家财政的主要资源消耗，非常有必要通过全面的财政和非财政政策来对其进行有效监管。
