Background Despite modest progress in reducing tobacco use, tobacco remains one of the major risk factors for non-communicable diseases in Bangladesh.
Methods Using disease-specific, prevalence-based, cost-of-illness approach, this research estimated the economic costs of tobacco use and exposure to secondhand smoke based on data collected from a nationally representative survey of 10 119 households in 2018.
Results The study estimated that 1.5 million adults were suffering from tobacco-attributable diseases and 61 000 children were suffering from diseases due to exposure to secondhand smoke in Bangladesh in 2018. Tobacco use caused 125 718 deaths in that year, accounting for 13.5% of all-cause deaths. The total economic cost was 305.6 billion Bangladeshi taka (BDT) (equivalent to 1.4% of gross domestic product or US$3.61 billion), including direct costs (private and public health expenditures) of BDT83.9 billion and indirect costs (productivity loss due to morbidity and premature mortality) of BDT221.7 billion. The total economic cost of tobacco more than doubled since 2004.
Conclusion Tobacco use imposes a significant and increasing disease and financial burden on society. The enormous tobacco-attributable healthcare costs and productivity loss underscore the need to strengthen the implementation of tobacco control policies to curb the epidemic.
- smoking caused disease
- global health
- low/middle income country
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Contributors NN designed the study and led the writing of the manuscript. GMF served as the subject matter expert in disease burden and cancer epidemiology. MA and IH undertook the data analysis and contributed to the preparation of the manuscript. RP, SNW and JD contributed to the writing of the manuscript. AKMGH supervised the survey design and implementation and contributed to data analysis and writing of the manuscript. All authors contributed to the revision of the manuscript.
Funding The research was funded by the Programme for Research, Advocacy and Capacity Building on Tobacco Taxation (PROACTT), a collaboration between Cancer Research UK and American Cancer Society, USA.
Competing interests None declared.
Patient consent for publication Not required.
Ethics approval Ethical clearance was obtained from the National Research Ethics Committee following the ethical guidelines of Bangladesh Medical Research Council (BMRC).
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement Deidentified data are available upon request from the Bangladesh Cancer Society 3 years after the collection of data when the embargo on data sharing is lifted.
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