RESEARCH PAPER

Economic burden of smoking in Korea

H Y Kang¹, H J Kim², T K Park³, S H Jee¹, C M Nam², H W Park⁴

¹ Graduate School of Health Science and Management, Yonsei University, Seoul, South Korea
² Department of Preventive Medicine, College of Medicine, Yonsei University
³ Department of Economics, School of Business and Economics, Yonsei University
⁴ Department of Medical Law and Ethics, College of Medicine, Yonsei University

Correspondence to:
Correspondence to: Hyoung Wook Park, Department of Medical Law and Ethics, College of Medicine, Yonsei University, 134 Shinchon-Dong, Seodaemun-Ku, Seoul, South Korea; hykang{at}yumc.yonsei.ac.kr

Objective: To support tobacco control policies in Korea by providing the estimated annual economic burden attributed to cigarette smoking.

Methods: The following two different approaches were used to estimate the cost: "disease specific" and "all causes". In the disease specific approach, we focused on estimating direct and indirect costs involved in treatments of cardiovascular, respiratory, and gastrointestinal diseases, and cancer as a result of smoking, by using an epidemiologic approach—the population attributable risk (PAR). To compute PAR, the relative risks of smoking in terms of physician visits, hospital admission, and death were estimated using the Cox proportional hazard model. In the all causes approach, we examined the differences in direct and indirect costs between smokers and non-smokers for all conditions and types of disease. The major data source was the Korea Medical Insurance Corporation cohort study, which had complete records of smoking status as of 1992 for 115 682 male and 67 932 female insured workers.

Results: By the disease specific approach, the estimated costs attributable to smoking in 1998 in Korea ranged from US$2269.42 million ($4.89 million per 100 000 population; 0.59% of gross domestic product (GDP)) to $2956.75 million ($6.37 million; 0.78% of GDP). The all causes approach yielded a minimum cost of $3154.75 million ($6.79 million; 0.82% GDP) and a maximum of $4580.25 million ($9.86 million; 1.19% GDP).

Conclusion: The study confirms that smoking places a substantial economic burden on Korean society. In light of this, our study provides evidence for a strong need to develop a national policy to effectively control tobacco consumption in Korea.

Keywords: economics; policy; Korea

Abbreviations: GDP, gross domestic product; KMIC, Korea Medical Insurance Corporation; PAR, population attributable risk; PYLL, potential years of life lost; RR, relative risk

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