The economic benefits of risk factor reduction in Canada: Tobacco smoking, excess weight and physical inactivity

OBJECTIVE: Tobacco smoking, excess weight and physical inactivity contribute substantially to the preventable disease burden in Canada. The purpose of this paper is to apply a recently developed approach in addressing the issue of double counting in estimating the combined current economic burden of these risk factors (RFs) and to estimate the economic benefits of long-term RF reduction in Canada. METHODS: We used an approach based on population attributable fractions (PAF) to estimate the economic burden associated with the various RFs. Sex-specific relative risk and age-/sex-specific prevalence data were used in the modelling when available. Excess weight was modelled as a trichotomous exposure (normal weight, overweight, obese) while tobacco smoking was modelled as a tetrachotomous exposure (non-smoker, light, medium or heavy smoker). All costs are given in constant 2012 Canadian dollars. RESULTS: The annual economic burden of the RFs of tobacco smoking, excess weight and physical inactivity in Canada are estimated at $50.3 billion in 2012. Sensitivity analysis suggests a range for the economic burden of $41.6 to $58.7 billion. Of the $50.3 billion, $21.3 ($20.0 to $22.6) billion is attributable to tobacco smoking, $19.0 ($13.8 to $24.0) billion to excess weight and $10.0 ($7.8 to $12.0) billion to physical inactivity. A 1% relative annual reduction in each of the three RFs would result in an $8.5 billion annual reduction in economic burden by 2031. CONCLUSION: A modest annual 1% relative reduction in the RFs of tobacco smoking, excess weight and physical inactivity can have a substantial health and economic impact over time at the population level.