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A study published in the American Journal of Medicine examined healthcare costs associated with smoking status using territory-wide public healthcare data from Hong Kong. Tingting Chen and colleagues analyzed healthcare spending among more than 1.5 million adults.
The retrospective cohort included 1,571,065 public healthcare users whose smoking status was recorded between 2008 and 2012, with follow-up through 2022. Of these participants, 14.3% were current smokers, 11.9% were former smokers, and 73.8% had never smoked. The researchers compared annual per-person costs across general and specialist outpatient clinics, accident and emergency services, and hospitalization.
Compared with never-smokers, current smokers had higher relative costs, with relative risks of 1.19 for specialist outpatient care, 1.40 for emergency services, and 1.57 for hospitalization. Sex-specific analyses showed higher cost multipliers for women than for men across these services. At the population level, the additional annual cost of public healthcare services was projected at about 726 million US dollars for current smokers and 336 million US dollars for former smokers. Together, these projected costs amounted to roughly 0.27% of Hong Kong's gross domestic product and 7.46% of total healthcare expenditures in 2023.
The authors noted that declines in smoking prevalence may not immediately reduce the associated economic burden because former smokers may continue to use healthcare services related to past exposure. They described accurate estimation of these costs as relevant to tobacco control policy.
