The 13th World Conference on Tobacco OR Health

Objective: In Brazil, there is not much research about the public health costs of treating tobacco-related diseases. The purpose of this study is estimate health care costs of tobacco related-diseases in two Brazilian public hospitals.

Methods: National Cancer Institute (NCI) and National Institute of Cardiology (NIC) are regional referrals for Rio de Janeiro for treatment of patients with cancer and heart diseases (HD). To select the diseases, we analyzed the frequency of hospitalizations of tobacco-related illness in each hospital in 2003. These results were pondered by smoking attributable fraction, according literature data. Five diseases were selected for cost analysis: esophagus, lung, and laryngeal cancers, angina pectoris and chronic ischemic heart disease. Costs will be computed from the viewpoint of the hospital and will be based on total medical consumption of a selected sample of patients registered in 2000 (NCI) and in 2001 (NIC). Comorbidity and stage are the prognostic factors of cost variations. The inclusion criteria of patients are: smoking status of patient (following WHO criteria), number of cigarettes/day, smoking exposed time, and tumor data. The selected comorbidities were: myocardial infarction, COPD, diabetes mellitus (DM), and hypertension (from cancer) and COPD, DM, esophagus, lung, and laryngeal cancers from HD. The stages of cancers will be subdivided in two groups. To select the cases to be subject of cost analysis, sub-populations based on comorbidities and stage groups will be created, and a simple random sample will be select from it.

Results: