The 13th World Conference on Tobacco OR Health

Objective: To estimate the cost of tobacco-related disease due to active and passive smoking

Methods: Using local routine and survey data, we estimated active and passive smoking-attributable mortality, hospital admissions, outpatient, emergency and general practitioner visits for adults and children, use of nursing homes and domestic help, time lost from work due to illness and premature mortality in the productive years. Morbidity risk data were used where possible but otherwise estimates were based on mortality risks. The attributable utilisation was valued at unit costs or as reported in surveys. Work time lost was valued at the median wage and a life lost at US$1.3 million.

Results: In the Hong Kong population of 6.5 million in 1998, the annual value of direct medical costs, long term care and productivity loss was US$532 million for active smoking and $156 million for passive smoking with passive smoking therefore accounting for 23% of the costs. Adding the value of attributable lives lost brought the annual cost to US$9.4 billion. There were areas of cost which could not be valued such as reduced quality of life for sufferers from tobacco-related disease and their families. Nonetheless, this quantification has been of great interest to policy-makers and has strengthened local arguments for smoke-free workplaces and public venues.