Passive smoking puts Rs 56,000 crore burden on healthcare

Exposure to second-hand tobacco smoke leads to more than Rs 56,000 crore worth of healthcare cost for Indians above 15 years, according to a new study that for the first time estimated India’s economic burden due to passive smoking.

The researchers showed that diseases caused by exposure to second-hand tobacco smoke put an economic burden of Rs 56,700 crore (in 2017) in health care costs, accounting for 0.33 per cent of India’s GDP. The burden is way above the Union Health Ministry’s annual budget in 2017 (nearly Rs 47,300 crore).

This is on top of the staggering Rs 1,80,000 crore ($27.5 billion) in annual economic burden from all types of tobacco use.

"Ours is the first study on the economic cost of second-hand smoking and it shows the healthcare cost is more than the last three year’s average annual tax revenue from all tobacco products,” health economist Rijo John, an adjunct professor at Rajagiri College of Social Sciences, Kochi and corresponding author of the study, told DH.

Those most affected by these costs are often the most economically vulnerable – women, young people, and those with lower incomes.

In their study, John and Estelle Dauchy, associate director at International Research Campaign for Tobacco-Free Kids in Washington DC demonstrated second-hand smoke attributable costs were higher among the youngest age group of 20-24 years and women bore 71 per cent of the direct medical costs attributable to passive smoking.

India has the world’s second-largest number of tobacco users (268 million or 28.6 per cent of all adults) of which at least 1.2 million die every year from tobacco-related diseases.

One million deaths are due to smoking with over 200,000 deaths due to second-hand smoke exposure and over 35,000 are due to smokeless tobacco use. Nearly 27 per cent of all cancers in India are due to tobacco usage.

In India, close to 39 per cent of adults are exposed to second-hand smoking at home and 30 per cent at work. But there is no estimate of the economic burden of any kind from indirect smoking.

For the study, the researchers used Global Adult Tobacco Survey data on tobacco exposure and the National Sample Survey Organisation’s data on health expenditure. Subsequently, they used statistical methods to derive the estimates.

The estimated burden, according to John, could actually be an underestimate as it did not include (1) impact on kids below 15 years, (2) consequences of premature death and (3) loss of productivity due to morbidity. Only the direct health care costs were taken into account.

Second-hand smoke contains more than 4,000 chemicals and over 50 carcinogens that can cause cardiovascular diseases, lung cancer and various other diseases and disabilities. Scientific studies have shown that there is no safe level of exposure to second-hand smoke.

“While India has made progress in reducing tobacco use, smoking continues to impose a drastic health and economic burden. India can save millions of lives and reduce this overwhelming burden through stronger tobacco control policies,” commented Pankaj Chaturvedi, head and neck cancer surgeon at Tata Memorial Hospital, who is not associated with the research.

Check out the latest videos from DH: