Research paper Tob Control: first published as 10.1136/tc.2008.027466 on 8 January 2009. Downloaded from Economic cost of tobacco use in India, 2004 R M John,1 H-Y Sung,2 W Max2 1 University of Illinois at Chicago, ABSTRACT smoked tobacco product in India, delivers nicotine, Institute for Health Research and Objective: To estimate the tobacco-attributable costs of carbon monoxide and other toxic components of Policy, Chicago, Illinois, USA; 2 University of California San diseases separately for smoked and smokeless tobacco tobacco smoke in equal or greater amounts than 6 Francisco, San Francisco, use in India. conventional cigarettes, making bidi smoking a California, USA Methods: The prevalence-based attributable-risk stronger risk factor than cigarette smoking for approach was used to estimate the economic cost of cancer of the hypopharynx and supraglottis.7 Correspondence to: tobacco using healthcare expenditure data from the R M John, University of Illinois at Many of the smokeless tobacco products in India Chicago, Institute for Health National Sample Survey, a nationally representative such as Khaini, Mawa, Pan, Zarda and Gutkh are Research and Policy (MC 275), household sample survey conducted in India in 2004. Four also found to be risk factors for cancer.7 Chewing 1747 West Roosevelt Road, major categories of tobacco-related disease—tuberculo- tobacco in India is also a risk factor for oral cancers Room 558, Chicago, Illinois 8 60608, USA;
[email protected] sis, respiratory diseases, cardiovascular diseases and and esophageal cancers. A recent nationwide neoplasms—were considered. study on smoking and mortality in India estimated Received 28 August 2008 Results: Direct medical costs of treating tobacco related that cigarette and bidi smoking causes about 5% of Accepted 11 December 2008 diseases in India amounted to $907 million for smoked all deaths in women and 20% of all deaths in men Published Online First tobacco and $285 million for smokeless tobacco.