Economic Costs of Diseases and Deaths Attributable to Tobacco Use in India, 2017-2018

Introduction: About 28.6% of Indian adults use tobacco.This study estimates the economic burden of deaths and diseases attributable to smoking and smokeless tobacco (SLT) use for persons aged >= 35 years. Methods: The National Sample Survey data on healthcare expenditures, the Global Adult Tobacco Survey data on tobacco use prevalence, and relative risks of all-cause mortality from tobacco use were used to estimate the economic burden of diseases and deaths attributable to tobacco use in India, using a prevalence-based attributable-risk approach. Costs are estimated under the following heads: (1) direct medical and nonmedical expenditures; (2) indirect morbidity costs; and (3) indirect mortality costs of premature deaths. Results: Total economic costs attributable to tobacco use from all diseases and deaths in India in the year 2017-2018 for persons 35 years or older amount to INR 1773.4 billion (US $27.5 billion), of which 22% is direct and 78% is indirect cost. Men bear 91% of the total costs. Smoking contributed 74% and SLT use contributed 26% of the costs. Conclusions: The economic costs of tobacco use amount to approximately 1.04% of India's gross domestic product (GDP), while the excise tax revenue from tobacco in the previous year was only 12.2% of its economic costs.The direct medical costs alone amount to 5.3% of total health expenditure. The enormous costs imposed on the nation's health care system due to tobacco use could potentially stress the public health care system and strain the economy and it warrants massive scaling up of tobacco control efforts in India.

Automated summary

According to this study, the total economic costs attributable to tobacco use in India for individuals aged 35 years and older in 2017-2018 amount to INR 1773.4 billion (US $27.5 billion), with direct costs accounting for 22% and indirect costs accounting for 78%. Men bear 91% of the total costs, with smoking contributing 74% and smokeless tobacco use contributing 26% of the costs.