Szklo Andre S
Coordenação de Prevenção e Vigilância, Instituto Nacional de Câncer, Rio de Janeiro, Brasil.
Cad Saude Publica. 2025 Aug 8;41(7):e00000125. doi: 10.1590/0102-311XPT000125. eCollection 2025.
In a country with about 20 million adult smokers, 174,000 deaths per year and BRL 153.5 billion in annual direct and indirect costs are attributable to smoking. The provision of brief advice to quit smoking by health professionals during any routine visit, as recommended by the World Health Organization, has enormous potential to reduce these numbers. For men and women aged 35 years or older, we estimated the deaths and total costs that could have been avoided if brief counseling had been offered to all smokers in Brazil in 2019 based on the most recent national data on smoking behavior and the costs of selected diseases (ischemic heart disease, stroke, chronic obstructive pulmonary disease, and lung cancer). If all 7.1 million smokers who did not receive brief counseling (49.7% of the total) had been approached, we could have had half a million more former smokers, i.e., representing a reduction of 642 deaths and saving, at the time, BRL 749.9 million. The highest numbers of deaths and cost savings would have been observed, respectively, among men for heart disease prevention and women for stroke prevention. Brazil still has a high absolute number of smokers and, therefore, the high costs associated with smoking should be analyzed using a population-based approach focused on reducing new cases and deaths from tobacco-related diseases. The resources saved by this strategy could be directed to meet the basic needs of the population, promoting health and improving quality of life.
在一个约有2000万成年吸烟者的国家，每年有17.4万人死于吸烟，吸烟造成的年度直接和间接成本达1535亿巴西雷亚尔。按照世界卫生组织的建议，卫生专业人员在任何常规就诊时提供简短的戒烟建议，对于减少这些数字具有巨大潜力。对于35岁及以上的男性和女性，我们根据巴西最新的吸烟行为数据以及特定疾病（缺血性心脏病、中风、慢性阻塞性肺疾病和肺癌）的成本，估算了如果在2019年向巴西所有吸烟者提供简短咨询，原本可以避免的死亡人数和总成本。如果接触到所有未接受简短咨询的710万吸烟者（占总数的49.7%），我们本可以多产生50万戒烟者，即减少642例死亡，并在当时节省7.499亿巴西雷亚尔。在预防心脏病方面，男性原本可避免的死亡人数和节省的成本最高；在预防中风方面，女性原本可避免的死亡人数和节省的成本最高。巴西吸烟者的绝对数量仍然很高，因此，应采用以人群为基础的方法来分析与吸烟相关的高昂成本，重点是减少烟草相关疾病的新病例和死亡人数。通过这一战略节省的资源可用于满足民众的基本需求，促进健康并提高生活质量。
