Smoking-attributable social and economic harm assessment in Lithuania

Despite plenty of scientific evidence and global efforts to reduce the prevalence of smoking, it remains one of the leading causes of non-communicable diseases and premature death worldwide. Often only the health effects of smoking are discussed, and socio-economic costs attributable to smoking are completely ignored. Though this aspect becomes even more relevant due to the limited financial resources of the health care systems and the pace of population ageing. Previously smoking-attributable socio-economic harm in Lithuania was almost exclusively assessed within framework of regional or global studies and national efforts were scarce and fragmented. This was partly due to the lack of relevant methodology. To address this problem, country-specific methodology to asses smoking-attributable harm was developed and is based on the recommendations and guidelines prepared by the World Health Organization and international experts. Based on the methodology developed, active and passive smoking-attributable mortality, morbidity, cases of disability and incapability to work were assessed. The socio-economic costs of smoking, including direct (healthcare and social security system) and indirect (morbidity and premature mortality, the loss of productivity from smoking breaks, the loss of productivity due to presenteeism) costs were estimated. Analysis showed that smoking remains an important cause of death in Lithuania, carrying over 6 thousand deaths a year. Smoking causes high socio-economic harm, which, according to conservative estimates, amounted to nearly €953 million in Lithuania in 2013, representing 2.7% of GDP. Estimated costs averaged to €322 per capita or €1,534 per smoker. Overall, smoking-attributable costs represented 3.5% of total healthcare expenditures, meanwhile social security system costs (including sickness benefits and disability and work capacity pensions) represented around 1% of the total budget of the Compulsory Health Insurance Fund. The socio-economic harm caused by smoking in Lithuania could be avoided by curbing the consumption of tobacco products. Therefore, despite significant progress in tobacco control, implementation of evidence-based tobacco control policies should be further strengthened. The aim of the study was to assess SA socio-economic harm in Lithuania in accordance with developed methodology. Objectives: 1) To assess active and passive SA mortality in 2003–2013. 2) To assess active and passive SA morbidity in 2003–2013. 3) To assess active and passive SA cases of disability and incapability to work in 2006–2013. 4) To estimate SA socio-economic costs in Lithuania in 2013 in accor-dance with developed methodology