Objective: To estimate current and future avoidable smoking-attributable costs in Sweden for the year 2007.
Design: Disease specific smoking-attributable proportions were calculated for Swedish smoking patterns and applied to estimate costs for smoking-related diseases based on data from public registers. Avoidable future effects of smoking were calculated employing a Markov simulation model.
Results: The estimated total cost in 2007 was USD 1.6 billion, or USD 181 per capita. Healthcare (direct) cost accounted for 30% of the total cost. The number of deaths was 97 per 100,000 inhabitants (79 in 2001); the number of years of potential life lost 1,227 per 100,000 inhabitants (1012 in 2001); and the number of years of potential productive life lost 226 (185 in 2001) per 100,000 inhabitants. Avoidable future lifetime costs, per 100,000 inhabitants, amounted to USD 19 million (healthcare), 14,000 years of potential life lost, corresponding to a present value of USD 158 million. Total avoidable cost of current smoking amounted to USD 16 billion.
Conclusion: In spite of declining smoking-prevalence rates during the last 30 years, smoking-attributable deaths increased between 2001 and 2007. The number of life years lost per death decreased somewhat, indicating that the age distribution of those dying shifted further towards older age. Simulations indicate that smoking-cessation among young smokers yields considerable more benefits each year than smoking-cessation among older smokers. The health benefits that accrued in 2007, as a result of declining smoking prevalence since 1980, correspond to more than the total cost of smoking in that year.
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