Olumide Adesola O, Shmueli Amir, Adebayo Emmanuel S, Omotade Olayemi O
Institute of Child Health, College of Medicine, University of Ibadan and University College Hospital, Ibadan, Nigeria.
Department of Health Management and Economics, School of Public Health, Hebrew University of Jerusalem, Jerusalem, Israel.
Z Gesundh Wiss. 2022;30(7):1701-1712. doi: 10.1007/s10389-021-01644-5. Epub 2021 Oct 27.
Cigarette smoking is an established cause of preventable death and often initiated during adolescence. We estimated the short- and long-term costs of cigarette smoking among currently smoking adolescents in Nigeria.
A cross-sectional survey among adolescents in Oyo state, Nigeria and a review of mortality records of patients managed for lung cancer in a tertiary facility in Ibadan, Nigeria were conducted. Short-term costs estimated were: (a) average weekly costs of purchasing cigarettes by currently smoking adolescents, and (b) costs of managing at least an episode of chronic cough occurring within 12 months of the survey. Long-term costs were limited to: (a) life-time expenditure on purchasing cigarettes, and (b) direct medical and non-medical (transportation) costs of managing lung cancer. Long-term costs were first projected to the approximate year when the adolescents (mean age:16.0 ± 1.8 years) might be diagnosed with lung cancer based on the average age at presentation with symptoms of lung cancer obtained from the records (59.8 years), and then discounted to 2020 prices. This was estimated as 44 years from the base year (2020). Costs were reported in 2020 prices in Nigerian Naira (NGN) and US dollar (USD) equivalent using the Central Bank of Nigeria, June 2020 exchange rate of USD 1: NGN 360.50.
Approximately 3.8% of the adolescents were current cigarette smokers. Average weekly expenditure on cigarettes was NGN 306.82 ± 5.74 (USD 0.85 ± 0.02). About 26% had experienced at least an episode of chronic cough which cost them an average of NGN 1226.81 ± 6.18 (USD 3.40 ± 0.02) to manage. Total future costs of cigarette smoking in 2020 prices for the 43 adolescents who were current smokers in the event that they develop lung cancer were approximately NGN 175.7 million (USD 487.3 thousand), NGN 871.8 million (USD 2.4 million) and NGN 4.6 trillion (USD 12.7 million) at assumed annual inflation rates of 10%, 15%, and 20% respectively and discount rate of 4.25%.
The estimated economic costs of smoking were very high. Efforts to prevent smoking initiation among adolescents in our study area should be intensified. Interventions to subsidize the medical cost of health-related consequences of cigarette smoking are also required, especially as treatment costs are currently largely borne out-of-pocket.
The online version contains supplementary material available at 10.1007/s10389-021-01644-5.
吸烟是可预防死亡的既定原因，且往往始于青春期。我们估算了尼日利亚目前吸烟青少年吸烟的短期和长期成本。
在尼日利亚奥约州的青少年中开展了一项横断面调查，并对尼日利亚伊巴丹一家三级医疗机构中接受肺癌治疗的患者的死亡率记录进行了回顾。估算的短期成本包括：（a）目前吸烟青少年购买香烟的平均每周成本，以及（b）管理调查12个月内至少一次慢性咳嗽发作的成本。长期成本仅限于：（a）购买香烟的终身支出，以及（b）肺癌治疗的直接医疗和非医疗（交通）成本。根据记录中肺癌症状出现时的平均年龄（59.8岁），首先将长期成本推算到这些青少年（平均年龄：16.0±1.8岁）可能被诊断为肺癌的大致年份，然后折算为2020年的价格。据估计，这距离基准年（即2020年）为44年。成本以2020年尼日利亚奈拉（NGN）和美元（USD）的价格报告，使用尼日利亚中央银行2020年6月1美元兑换360.50奈拉的汇率进行换算。
约3.8%的青少年目前吸烟。购买香烟的平均每周支出为306.82±5.74奈拉（0.85±0.02美元）。约26%的青少年至少经历过一次慢性咳嗽发作，管理这些咳嗽发作平均花费他们1226.81±6.18奈拉（3.40±0.02美元）。假设年通货膨胀率分别为10%、15%和20%，贴现率为4.25%，对于43名目前吸烟的青少年，如果他们患肺癌，2020年价格下吸烟的未来总成本约为1.757亿奈拉（48.73万美元）、8.718亿奈拉（240万美元）和4.6万亿奈拉（1270万美元）。
吸烟的估计经济成本非常高。应加强在我们研究地区预防青少年开始吸烟的努力。还需要采取干预措施补贴吸烟对健康相关后果的医疗费用，特别是因为目前治疗费用大多由个人自掏腰包。
在线版本包含可在10.1007/s10389-021-01644-5获取的补充材料。
