Intended for healthcare professionals

Clinical Review ABC of smoking cessation

Economics of smoking cessation

BMJ 2004; 328 doi: (Published 15 April 2004) Cite this as: BMJ 2004;328:947
  1. Steve Parrott, research fellow,
  2. Christine Godfrey, professor
  1. Centre for Health Economics at the University of York
  2. Department of Health Sciences at the University of York


    Smoking imposes a huge economic burden on society—currently up to 15% of total healthcare costs in developed countries. Smoking cessation can save years of life, at a very low cost compared with alternative interventions. This chapter reviews some of the economic aspects of smoking cessation.

    Self rated health status (100 = best imaginable health state), by age and smoking status. Data from Kind et al.UK population norms for EQ-5D. York: Centre for Health Economics (Discussion paper 172)

    Who benefits from cessation?

    The most obvious benefits of smoking cessation are improvements in life expectancy and prevention of disease. However, cessation also improves individuals' quality of life as smokers tend to have a lower self reported health status than non-smokers, and this improves after stopping smoking.

    View this table:

    Benefits of smoking cessation

    There are also wider economic benefits to individuals and society, arising from reductions in the effects of passive smoking in non-smokers and savings to the health service and the employer. These wider benefits are often omitted from economic evaluations of cessation interventions, which consequently tend to underestimate the true value for money afforded by such programmes.

    Economic burden of smoking

    Many estimates have been made of the economic cost of smoking in terms of health resources. For the United States they typically range from about 0.6% to 0.85% of gross domestic product. In absolute terms, the US public health service estimates a total cost of $50bn (£29bn;€42bn) a year for the treatment of smoking related diseases, in addition to an annual $47bn in lost earnings and productivity. Estimated total costs in Australia and Canada, as a proportion of their gross domestic product, are 0.4% and 0.56% respectively. In the United Kingdom, the treatment of smoking related disease has been estimated to cost the NHS £1.4bn-£1.5bn a year (about 0.16% of the gross domestic product)—including £127m to treat lung cancer …

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