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. 2016 Oct;40(4):213-221.

[Financial impact of smoking on health systems in Latin America: A study of seven countries and extrapolation to the regional level]

[Article in Spanish]
Andrés Pichon-Riviere  1 , Ariel Bardach  1 , Federico Augustovski  1 , Andrea Alcaraz  1 , Luz Myriam Reynales-Shigematsu  2 , Márcia Teixeira Pinto  3 , Marianela Castillo-Riquelme  4 , Esperanza Peña Torres  5 , Diana Isabel Osorio  5 , Leandro Huayanay  6 , César Loza Munarriz  6 , Belén Sáenz de Miera-Juárez  2 , Verónica Gallegos-Rivero  7 , Catherine De La Puente  8 , María Del Pilar Navia-Bueno  9 , Joaquín Caporale  1
Affiliations
  • PMID: 28001196

[Financial impact of smoking on health systems in Latin America: A study of seven countries and extrapolation to the regional level]

[Article in Spanish]
Andrés Pichon-Riviere et al. Rev Panam Salud Publica. 2016 Oct.

Abstract

Objective: Estimate smoking-attributable direct medical costs in Latin American health systems.

Methods: A microsimulation model was used to quantify financial impact of cardiovascular and cerebrovascular disease, chronic obstructive pulmonary disease (COPD), pneumonia, lung cancer, and nine other neoplasms. A systematic search for epidemiological data and event costs was carried out. The model was calibrated and validated for Argentina, Bolivia, Brazil, Chile, Colombia, Mexico, and Peru, countries that account for 78% of Latin America's population; the results were then extrapolated to the regional level.

Results: Every year, smoking is responsible for 33 576 billion dollars in direct costs to health systems. This amounts to 0.7% of the region's gross domestic product (GDP) and 8.3% of its health budget. Cardiovascular disease, COPD, and cancer were responsible for 30.3%, 26.9%, and 23.7% of these expenditures, respectively. Smoking-attributable costs ranged from 0.4% (Mexico and Peru) to 0.9% (Chile) of GDP and from 5.2% (Brazil) to 12.7% (Bolivia) of health expenditures. In the region, tax revenues from cigarette sales barely cover 37% of smoking-attributable health expenditures (8.1% in Bolivia and 67.3% in Argentina).

Conclusions: Smoking is responsible for a significant proportion of health spending in Latin America, and tax revenues from cigarette sales are far from covering it. The region's countries should seriously consider stronger measures, such as an increase in tobacco taxes.

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