Societal costs of smoking

The burden of smoking-related diseases on society is enormous. It has been estimated that about 100 million people worldwide were killed by tobacco in the 20th century, and that the number will increase to 1 billion in the 21st century. It is estimated that in 2000, about 4.83 million deaths worldwide were attributable to tobacco smoking (12% of the estimated total global mortality among adults aged 30 years or older), with about 2.43 million of these in industrialised countries (19% of total adult mortality). The leading causes of death from tobacco smoking were cardiovascular diseases (1.69 million deaths), COPD (0.97 million) and lung cancer (0.85 million). In Europe, smoking leads to more than 650 000 premature deaths every year. Only 15% of the world’s population live in Europe, but nearly a third of the burden of tobacco-related diseases occurs in Europe.

Smoking places a tremendous economic burden on society worldwide. The WHO estimates that the drain on the world economy is so large that it exceeds the total annual expenditure on health in all low- and middle-income countries. The total economic costs of tobacco reduce national wealth in terms of gross domestic product (GDP) by as much as 3.6%. In Europe, the burden from smoking, according to a report submitted to the EC in 2012, cost the economy €544 billion in 2009 – equivalent to about 4.6% of the EU’s GDP.

According to the WHO, the economic burden of tobacco is particularly high in the developing world and by 2030 four out of five tobacco-related deaths will occur in less developed countries. The poor are disproportionately affected, because buying tobacco diverts expenditure from necessities, including food, shelter, education and healthcare.

The economic costs of smoking extend beyond the direct costs of smoking-related illness and death and can be attributed to four elements:

  1. Healthcare expenditures attributable to the treatment of smoking-related diseases in active smokers and those affected by second-hand smoke.
  2. Loss of earnings, employee absence and reduced workplace productivity.
  3. The monetised value of premature mortality and disability as assessed by disability-adjusted life-years lost.
  4. Other indirect costs such as fire damage related to smoking and costs related to cleaning up after smoke. Smoking is the biggest cause of discarded litter in many cities. Tobacco growing results in widespread environmental harm from deforestation as well as pesticide and fertiliser contamination.

See the entire Tabacco smoking Chapter