[Brief counseling in routine consultations: a population-based strategy to reduce the disease and the economic burdens of smoking in Brazil].

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.