DISAGGREGATION OF TANGIBLE COSTS

							ECONOMICS
    OF
 TOBACCO
  EPIDEMIOLOGICAL
       MEDICAL
          &
 ECONOMIC EVIDENCE
 RELATING TO EFFECTS
AND COSTS OF TOBACCO
    CONSUMPTION
   ALL CONTINUE TO
     ACCUMULATE
    Economic Public Policies
      Address Strategies
              to
  Reduce Tobacco Dependence
             through

 Reducing Uptake
 Reducing Consumption
 Subsidies For Cessation Products
 Enforcement of Regulations to
 Protect Non-Smokers
              Social Costs
               also called
External Costs Are All Costs
 Other Than Private Costs
    Private Costs Are Knowingly & Freely Borne
                   By Consumers
            Social Costs Include:-
    Costs Borne by Tobacco Users Who Are Not
     Fully Informed (eg of addictive properties
     of nicotine)
    Costs Borne By Families Of Tobacco Users
    Health Costs Borne By Governments
    Costs of Environmental Tobacco Smoke
Economic Tools
              Taxes on Tobacco Products

        Support For Public Health Programs

   Enforcement of Public Health Regulations

       Subsidy For Quit Programs & Products
  Tobacco Taxes Should
        Reflect
                       Both


Revenue Source (as with all taxed
      consumption products in many countries)
                        and

Contribution to Pollution &
        Health Costs
  (as with industrial polluters in many countries)
  Enforcement of Smoking
   Bans in Public Places
Economic Issues Include:
 Societal Acceptance
 Ease of Enforcement
 Cost of Enforcement
 Reduced or Expanded Trade & Profits Through
Provision of Non-Smoking Facilities
      ROLE OF GUIDELINES

   ECONOMIC COST OF INTERVENTIONS
   ECONOMIC EVALUATION OF
      INTERVENTIONS
   COST OF ALTERNATIVES
    (RELATIVE COST-EFFECTIVENESS)
   INTERVENTIONS RE
    ACTIVE SMOKING

 SUBSIDIES FOR QUIT ACCESS
 MANAGEMENT OF NICOTINE
    DEPENDENT INPATIENTS
 SUBSIDIES FOR
    PHARMACOTHERAPIES
 PAYMENT TO HEALTH
    PROFESSIONALS
 INTERVENTIONS REGARDING
   INVOLUNTARY SMOKING
 Reduction Of Exposure Of Children &
  Infants
 Support For Smoking Cessation During
  Pregnancy
 Smoking Bans In Restaurants, Clubs &
  Bars

         ECONOMIC ISSUES
     • COSTS
     • EXPOSURE
     • EXTERNALITIES
ESTIMATION OF TOBACCO
        COSTS
      ECONOMIC POLICY ISSUES
   SMOKING PREVALANCE
   COSTS OF SMOKING
   TAX REVENUE
   COST OF INTERVENTIONS
   COST OF REGULATION
   REGULATORY COMPLIANCE
  DISAGGREGATION OF
    TANGIBLE COSTS
1) HEALTH CARE COSTS
  • HOSPITAL SERVICES
   INPATIENT-DIAGNOSTIC
   CATEGORY /CASEMIX
   OUTPATIENT-CLINIC/
   SUB-ACUTE/NON-ACUTE
  • LONG-TERM CARE
   NURSING HOMES, HOSTELS, HOSPICES
  • MEDICAL SERVICES
  • PRESCRIPTION &
     NON-PRESCRIPTION DRUGS
  • ALLIED HEALTH SERVICES
DISAGGREGATION OF
  TANGIBLE COSTS
2) PRODUCTION LOSSES
  resulting from
   DEATH
   SICKNESS
   REDUCED PRODUCTIVITY
  – eg time for smoking, reduced health
    status of smokers
DISAGGREGATION OF
  TANGIBLE COSTS

  3) WELFARE PROVISION
  • UNEMPLOYMENT
  • SICKNESS & INVALIDITY
  PAYMENTS and/or PENSIONS
DISAGGREGATION OF
  TANGIBLE COSTS
4)   FIRES
     DOMESTIC / INDUSTRIAL
     / ENVIRONMENTAL

5)   POLLUTION, LITTER

6)   RESEARCH. EDUCATION

7)   SMUGGLING
DATA DEFICIENCIES &
    ESTIMATES
• DOCTRINE OF CONSERVATIVE
      ESTIMATION
•   USE OF EPIDEMIOLOGICAL DATA FROM
      COMPARABLE COUNTRIES
•   USE OF SAMPLE DATA
•   PASSIVE SMOKING (ETS)
•   USE OF PROXY DATA
•   SMUGGLING / TAX AVOIDANCE
DISAGGREGATION OF
 INTANGIBLE COSTS
 • LOSS OF LIFE by
  • SMOKERS
  • PASSIVE SMOKERS
 •PAIN & SUFFERING of
   • SMOKERS
   • PASSIVE SMOKERS
   • OTHERS
AVOIDABLE COSTS

   ESTIMATION
   ANALYSIS
   POLICY OPTIONS