Smoking costs $1.44 trillion in health care and labour losses: study

February 10, 2017

The detrimental impact of smoking on national health systems and economies has been widely studied since the early 1960s but has always been focused exclusively on high income countries. The latest article published by the Journal: Tobacco Control on 30th January 2017 includes low and middle income countries with more accurate estimates of the total global cost. Data from 152 countries representing 97% of the world’s smokers, from Africa, the Americas, the Eastern Mediterranean, Europe, Southeast Asia, and the Western Pacific was gathered and analysed. The results showed that the killer habit consumed the equivalent of nearly 2% of the global economic output or GDP with nearly 40% of that burden falling on developing countries.

The researchers used the ‘cost of illness’ approach which was first devised in 1960. This divides the economic impact of an illness into direct costs, such as hospital admissions and treatment, and indirect costs representing the value of productivity lost to death and disability in current and future years, for a given year. The direct and indirect costs are then added up to provide the overall societal cost, usually expressed as a percentage of annual gross domestic product (GDP). These showed that in 2012, diseases caused by smoking accounted for 12% (2.1 million) of all deaths among working age adults aged 30-69 and 1.4 million of these adults would have been employed. They then calculated the number of working years lost due to the smoking related ill health and this added up to 26.8 million, 18 million of which were lost to death with the remainder lost to disability. It is important to point out that these calculations did not include the health and economic harms caused by second hand smoke or smokeless forms of tobacco, and that their estimates of lost productivity applied only to those who were economically active. In other words this staggering figure for 2012 is on the conservative side!

These findings highlight the urgent need for all countries to implement comprehensive tobacco control measures to address these economic costs. If the countries are to reach their goal for Sustainable Development which is to cut early deaths from non-communicable diseases such as those caused by smoking by a third by 2030, a lot of work needs to be done.

Curbing the habit globally would go a long way to achieving this goal. The South African government has been very proactive in its bid to reduce smoking. They have introduced heavy “sin” taxes on all tobacco products and there has been a drop in the prevalence of smoking mainly attributable to sharp increases in cigarette prices. They have also banned advertising and promotion of cigarettes and smoking in public places.  As the government intensifies the fight against tobacco smoking the Department of Health is busy preparing a Draft Bill to introduce plain packaging of tobacco products. This measure was introduced in the UK, Northern Ireland and France in May 2016, and the Cancer Association of South Africa (CANSA) welcomes its introduction here. The purpose of plain packaging is to make tobacco products less attractive. Graphic warnings will show the harmful effects of smoking. Plain packaging restricts the use of logos, colours, brand images and promotional information.

Prevention is always better than cure and the legislative measures to deter new people from starting smoking is the best approach to preventing death and disability due to tobacco related diseases. According to a study published in the South African Medical Journal (2010) smoking causes an estimated eight percent of adult deaths in South Africa and since current estimates are that nearly 8 million South Africans smoke, something urgently needs to be done to help these smokers.

CANSA encourages people to reduce their cancer risk by quitting smoking and enjoy the benefits of a healthier lifestyle. Cessation rates however, are low. Stopping smoking is hard and many ex-smokers say that quitting smoking was the hardest thing they ever did. However, millions of smokers have managed to quit smoking and any smoker who really wants to stop smoking can.

The best way to quit smoking involves a combination of the following:

  • A willingness to stop smoking – sounds simplistic but a smoker must want to quit smoking
  • The right attitude – to believe that they can stop smoking
  • Support – to teach problem solving, coping skills and to guide the smoker
  • Behaviour modification – trigger avoidance and management, creating a healthier lifestyle
  • Medication – products (such as nicotine replacement therapy) to help quit smoking & assist with nicotine withdrawal (if indicated)

Smokers who are serious about improving their health by stopping smoking should consider using an evidence based smoking cessation programme to give them their best chance of success.

Tips to quit smoking

Current research shows that the best way to quit smoking is through a smoking cessation program which includes support, behavioural modification and traditional nicotine replacement therapy such as medical nicotine gum or patches.

A smoker can triple their chance of successfully stopping smoking by using a combination smoking cessation programme such as GoSmokefree. Visit or email for more information.


This article contains opinions and facts and references to other information sources. You should always consult a registered healthcare professional for any personal advice.

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