RESEARCH PAPERS

The impact of smoking and quitting on household expenditure patterns and medical care costs in China

Ying Xin¹, Juncheng Qian¹, Ling Xu¹, Shenglan Tang², Jun Gao¹, Julia Alison Critchley³

¹ Centre for Health Statistics and Information, Ministry of Health, Beijing, China;
² Liverpool School of Tropical Medicine, China;
³ Newcastle University, China

E-mail: j.a.critchley{at}ncl.ac.uk

Background: Smoking remains very common in Chinese men, and the economic burden caused by cigarette consumption on smokers and their families may be substantial. Using a large nationally representative household survey, the third National Health Services Survey (NHSS, 2003), we estimated the economic impact of smoking on households.

Methods: Smoking status of all household members (over 15 years) was collected by interview for the NHSS, and households classified into 1 of 7 categories based on their smoking status. Information on household income and expenditure, and use of health services was also obtained. We assessed both the "direct" costs (reducing funds available for spending on other commodities such as food, education, medical care etc. using a fractional LOGIT model), and "indirect costs" (increasing medical expenditures, using a log-linear model).

Results: Every 5 packets of cigarettes consumed per capita per month reduces household spending on other commodities; most notably on education (by about 17 yuan per capita per annum), and medical care (11 yuan). The effects are greatest among low income rural households. Households with quitters spend substantially more on medical care than never-smoking households (64 yuan for households with 2 or more quitters).

Conclusions: If a household member smokes or has quit, there is less money available for commodities such as education and medical care. Medical care expenditure is substantially higher among households with quitters, as ill-health is the main reason for quitting smoking in China. Smoking impoverishes a substantial number of poorer rural households.

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