RESEARCH ARTICLE Open Access The association of smokin utilisation, productivity los

Full list of author information is available at the end of the articleBackground Worldwide, tobacco smoking is seen as the most urgent health risk behaviour requiring prevention today [1]. The list of diseases caused by smoking includes cancer, cardiovascular diseases, respiratory illnesses and many more [2]. Smoking significantly reduces health-related quality of life [3,4] and is responsible for more than five million deaths worldwide every year [5]. Mortality and morbidity associated with smoking have considerable fi-nancial consequences for healthcare systems and econ-omies [6,7]. In Germany, smoking is still prevalent despite a reduction in recent years: 30 % of the population aged 18 and older are smokers, 26 % former smokers, while 44% have never smoked [8]. Previous studies have shown that smoking results in higher utilisation of medical services [9,10], augmented work absenteeism [11-13] and in-creased resulting costs [14,15]. Despite their shortened lif