Table 10-5. – Annual economic burden attributable to tobacco, by cause, for Brazil, 2020 (US$ millions).

Economic burden (US$ millions)	Brazilian data for 2020
Direct medical cost (%)	9347.4 (38.5)
Caregiver cost (%	6023.7 (24.8)
Productivity cost (%)	6023.7 (24.8)
Total economic burden	24 301.3 (100%
As a proportion of GDP	1.9%
Proportion recovered through taxes	9.4%
Direct medical cost (US$ millions)
CVD	2280.4 (24.4%)
Stroke	447.0 (4.8%
COPD	4307.8 (46.1%)
Pneumonia	31.2 (0.3%)
Lung cancer	453.2 (4.8%)
Other cancers	751.8 (8.0%)
Second-hand smoke	1076.0 (11.5%)
Total direct medical cost	9347.4 (100%)
Proportion of national health expenditure	7.8%
Productivity cost (US$ millions)
Premature death
CVD	917.7 (26.4%)
Stroke	324.8 (9.4%)
COPD	469.8 (13.5%)
Pneumonia	161.7 (4.7%)
Lung cancer	452.2 (13.0%)
Other cancers	739.8 (21.3%)
Second-hand smoke	405.9 (11.7%)
Total premature deaths	3471.8 (100%)
Disability
CVD	1368.4 (25.1%)
Stroke	375.0 (6.9%)
COPD	1544.7 (28.3%)
Pneumonia	00.9 (0.0%)
Lung cancer	547.4 (10.0%)
Other cancers	988.3 (18.1%
Second-hand smoke	633.7 (11.6%)
Total disability	5458.4 (100%)
Premature death	3471.8 (38.9%)
Disability	5458.4 (61.1%)
Total productivity cost	8930.2 (100%)
Costs of caregivers (US$ millions)
CVD	2160.5 (35.9%)
Stroke	530.0 (8.8%)
COPD	1918.1 (31.8%)
Pneumonia	39.0 (0.6%)
Lung cancer	224.3 (3.7%)
Other cancers	457.9 (7.6%)
Second-hand smoke	693.8 (11.5%)
Total cost of caregivers	6023.7 (100%)

CVD: cardiovascular disease; COPD: chronic obstructive pulmonary disease; GDP: gross domestic product. Source: Adapted from Pichon-Riviere et al. ³⁵⁴