The Economic Burden of Smoking‑Attribution and Years of Life Lost due to Chronic Diseases in Mashhad, 2015–2016

Mehdi Varmaghani, Malihe Ghobadi, Farshad Sharifi, Payam Roshanfekr, Ali Sheidaei, Masoume Mansouri Masoume Mansouri, Amin Adel, Mohammad Mohammadi, Mohammad Reza Masjedi


Background: Tobacco smoking is one of the most preventable causes of mortality related to noncommunicable diseases (NCDs). This study aimed to estimate the direct economic burden and years of life lost (YLL) attributable to smoking in NCDs in Mashhad, 2015–2016.

Methods: Hospital‑based data were utilized to calculate the economic burden of four selected diseases related to smoking. An epidemiological population‑attributable risk method was used to determine the smoking‑attributable fraction (SAF). Moreover, the study was conducted by data related to disease‑specific expenditures and patients’ information on cost and the number of mortality for estimating the YLL for each disease, population and life expectancy data, the prevalence of smoking, and the relative risk of smoking. Data analysis was performed with STATA software, version 12.

Results: The total costs attributable to smoking for stroke, myocardial infarction, chronic obstructive pulmonary disease (COPD), and lung cancer were 94148, 151272, 1191396, and 574784 US Dollars, respectively (per 100000). In 2015, the YLL per deaths due to COPD were 4217 and 3522 among males and females, respectively. Furthermore, in 2016, the YLL per deaths due to the stroke in males and females were 8317 and 7563, respectively. In the same year, the highest proportion of years of potential life lost per 100000 smoking‑attributable deaths belonged to COPD.

Conclusions: The results of this study can be used to inform policy‑makers about smoking‑attributable diseases in Iran. To decrease the smoking‑attributable costs, which have resulted in the spread of NCDs, policy‑makers should adopt and implement effective policies regarding smoking prevention and control.


Global burden of disease; health care costs; lung neoplasms; myocardial infarction; smoking; stroke

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