Bakhtiari Aliabad Mohammad, Masoudi-Asl Iravan, Abolhallaje Masoud, Jafari Mehdi
Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran.
Ministry of Health and Medical Education, National Center for Strategic Research in Medical Education, Tehran, Iran.
Addict Health. 2023 Apr;15(2):128-135. doi: 10.34172/ahj.2023.1375. Epub 2023 Apr 29.
Tobacco is a major cause of preventable morbidity and mortality, with a considerable economic burden. The purpose of this systematic review was to summarize the evidence on the economic burden of tobacco use by searching national and international databases so as to generate useful information about the costs of tobacco use globally.
A systematic search was conducted in Scopus, PubMed, EMBASE, ProQuest, and Web of Science (ISI) databases to identify relevant studies from 1990 to June 2021 using keywords like burden, productivity, indirect cost, direct cost, economic, monetary, expenditure, tobacco, smoking, and cigarettes. Cost estimates were converted into 2020 international dollars per adult.
A total of 1,781 articles were identified, of which 361 were deemed to be eligible for inclusion. Eventually, 23 articles were found eligible. In most studies, cost estimates were provided using a prevalence-based approach. The highest total cost, as a percentage of gross domestic product (GDP), was reported for South Korea (1.19%). Noteworthy, in all studies, indirect costs accounted for the highest proportion of all costs. The mean total cost amounted to 5,866 million dollars. The direct costs ranged from 179 million dollars in South Korea to 8,156 million dollars in Israel. Meanwhile, the indirect costs ranged from 289 million dollars in Hong Kong to 9,808 million dollars in India.
The evidence demonstrated the considerable economic burden of tobacco use in various countries, ranging from 0.33 to 1.19% of the GDP of the investigated countries, indicating the necessity of taking immediate measures. Hence, policies are needed to address the economic burden of smoking.
烟草是可预防发病和死亡的主要原因，带来了相当大的经济负担。本系统评价的目的是通过检索国内和国际数据库，总结关于烟草使用经济负担的证据，以便生成全球烟草使用成本的有用信息。
在Scopus、PubMed、EMBASE、ProQuest和Web of Science（ISI）数据库中进行系统检索，以识别1990年至2021年6月期间的相关研究，使用的关键词如负担、生产力、间接成本、直接成本、经济、货币、支出、烟草、吸烟和香烟。成本估计数换算为每位成年人2020年国际美元。
共识别出1781篇文章，其中361篇被认为符合纳入标准。最终，发现23篇文章符合要求。在大多数研究中，成本估计采用基于患病率的方法。韩国报告的总成本占国内生产总值（GDP）的比例最高（1.19%）。值得注意的是，在所有研究中，间接成本在所有成本中占比最高。平均总成本达58.66亿美元。直接成本从韩国的1.79亿美元到以色列的81.56亿美元不等。同时，间接成本从香港的2.89亿美元到印度的98.08亿美元不等。
证据表明，各国烟草使用造成了相当大的经济负担，占被调查国家GDP的0.33%至1.19%，这表明有必要立即采取措施。因此，需要制定政策来应对吸烟带来的经济负担。
