Research Unit on the Economics of Excisable Products (REEP), School of Economics, University of Cape Town, Rondebosch, South Africa.
School of Economics and Finance, University of Witwatersrand, Johannesburg, South Africa.
Nicotine Tob Res. 2021 Jan 22;23(2):286-293. doi: 10.1093/ntr/ntaa162.
Chronic, noncommunicable diseases are on the rise globally, with tobacco consumption being an important contributing risk factor. These increases result in significant economic costs due to increased healthcare costs, productive lives lost, and productive days lost due to illness. Estimates of these economic costs are scarce in low- and middle-income countries.
Drawing on a diverse range of data sources, direct healthcare costs, and productivity losses due to illness and premature deaths were estimated using the cost-of-illness approach. The present value of lifetime earnings was used to estimate productivity losses from premature deaths.
We estimate that 25 708 deaths among persons aged 35-74 in 2016 are smoking-attributable. The economic cost of smoking was R42 billion (US$2.88 billion), of which R14.48 billion was for healthcare costs (hospitalization and outpatient department visits). The economic cost of smoking amounted to 0.97% of the South African GDP in 2016, while the healthcare cost of smoking-related diseases was 4.1% of total South African health expenditure. The costs are lower for women because of their lower smoking prevalence.
The economic burden of smoking calls for a further scaling-up of tobacco-control interventions in South Africa.
This article addresses the paucity of research on the detailed economic costs of smoking in low-and middle-income countries, including South Africa. Our calculations, based on an extensive range of recent data, provide the most detailed estimate to date and include quantification of the direct and indirect costs of smoking in South Africa. We found that the magnitude of the costs related to smoking in South Africa is larger than in the previous estimates and that for every Rand received in the form of cigarette tax, society loses 3.43 Rands. This article provides an economic case for evidence-based tobacco control in South Africa.
慢性非传染性疾病在全球呈上升趋势，而烟草消费是一个重要的致病因素。这些疾病导致医疗保健费用增加、丧失生产性生命以及因疾病而丧失生产性天数，从而导致巨大的经济成本。在中低收入国家，这些经济成本的估计数据很少。
本研究利用多种数据源，采用疾病成本法估算了直接医疗成本以及因疾病和过早死亡导致的生产力损失。利用终身收入的现值估算了过早死亡导致的生产力损失。
我们估计，2016 年 35-74 岁人群中有 25708 人死于与吸烟相关的疾病。吸烟的经济成本为 420 亿兰特（28.8 亿美元），其中 144.8 亿兰特用于医疗保健（住院和门诊就诊）。2016 年，吸烟的经济成本占南非国内生产总值的 0.97%，而与吸烟相关的疾病的医疗保健成本占南非卫生总支出的 4.1%。由于女性吸烟率较低，因此女性的吸烟成本较低。
吸烟的经济负担要求南非进一步扩大烟草控制干预措施。
本文解决了包括南非在内的低收入和中等收入国家对吸烟详细经济成本研究不足的问题。我们的计算基于广泛的最新数据，提供了迄今为止最详细的估计，并量化了南非吸烟的直接和间接成本。我们发现，南非与吸烟相关的成本规模大于以前的估计，而且每收到 1 兰特的香烟税，社会就损失 3.43 兰特。本文为南非基于证据的烟草控制提供了一个经济案例。
