The 13th World Conference on Tobacco OR Health

Objective: To compare direct health care costs of inpatients with cardiovascular diseases, according to smoking behaviours, in a private clinic of a developing country.

Methods: The sample (N=53) was obtained in a private clinic of the city of San Salvador de Jujuy, Argentina, by means of clinical charts review of all patients admitted between April and November 2004 with acute ischemic syndrome (cardiac, stroke, peripheral). Patients were classified as current smokers; past year quitters, and abstainers for more than one year; never smokers exposed to secondhand smoke (SHS), and not exposed to SHS. Direct costs were obtained for each patient from the clinic's accounting reports and included personnel, supplies, materials, and medical tests and procedures.

Results: 63 % of the sample were men, 41% were 40 to 60 years of age and 59% were 61 to 80 years. Percentage of smokers and cost per patient were as follows: 38% smokers with US$1,574 cost; 17% past year quitters with US$1,883 cost; 16% abstainers for more than one year with US$1,226 cost; 9% non-smokers exposed to SHS with US$ 1,296 cost; 21% non-smokers not exposed to SHS with US$1,296 cost. Conclusion: almost 80 % of patients were exposed to tobacco smoke. Costs for smokers and past year quitters were about double the cost for non-smokers not exposed to SHS. Higher costs were due largely to differences in costs of medical tests and procedures. Smoking and exposure to SHS impose a heavy burden on health care systems in developing countries.