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. 2023 May 4;33(5):e057618. doi: 10.1136/tc-2022-057618

Table 2. Annual economic burden attributable to tobacco, by cause and country for 2020 (US$ millions).

Economic burden (US$ millions) Argentina Brazil Chile Colombia Costa Rica Ecuador Mexico Peru Total
Direct medical cost (%) 2782.5 (52.3) 9347.4 (38.5) 1959.0 (45.0) 1169.6 (50.6) 285.1 (53.8)  655.7 (49.5) 5370.8 (59.6) 1215.2 (45.8) 22 785.4(45.8)
Caregiver cost (%) 1068.9 (20.1) 6023.7 (24.8) 1196.3 (27.5) 519.0 (22.4) 100.0 (18.9)  312.2 (23.6) 922.7 (10.2) 700.1 (26.4) 10 843.0 (21.8)
Productivity cost (%) 1470.1 (27.6) 8930.2 (36.7) 1193.7 (27.4) 624.6 (27.0) 145.3 (27.4)  355.5 (26.9) 2720.7 (30.2) 735.8 (27.8) 16 175.7(32.5)
Total economic burden 5321.4(100%) 24 301.3(100%) 4349.0(100%) 2313.2(100%) 530.5(100%) 1323.4 (100%) 9014.2(100%) 2651.1(100%) 49 804.2(100%)
As a proportion of GDP 1.3% 1.9% 1.8% 0.9% 0.9% 1.3% 0.9% 1.3% 1.4%
Proportion recovered through taxes 25.4% 9.4% 27.1% 14.3% 8.8% 7.3% 22.5% 4.4% 14.9%
Direct medical cost (US$ millions)
CV disease 780.0 (28.0%) 2280.4 (24.4%) 505.3 (25.8%) 362.2 (31.0%) 118.1 (41.4%) 274.4 (41.9%) 1797.4 (33.5%) 146.8 (12.1%) 6264.6(27.5%)
Stroke 53.5 (1.9%) 447.0 (4.8%) 204.3 (10.4%) 83.2 (7.1%) 06.8 (2.4%) 48.4 (7.4%) 321.1 (6.0%) 154.0 (12.7%) 1318.3(5.8%)
COPD 521.4 (18.7%) 4307.8 (46.1%) 490.3 (25.0%) 344.2 (29.4%) 57.2 (20.1%) 168.4 (25.7%) 1995.0 (37.1%) 452.0 (37.2%) 8336.3(36.6%)
Pneumonia 16.6 (0.6%) 31.2 (0.3%) 01.3 (0.1%) 04.9 (0.4%) 01.4 (0.5%) 02.2 (0.3%) 55.5 (1.0%) 04.5 (0.4%) 117.6(0.5%)
Lung cancer 606.3 (21.8%) 453.2 (4.8%) 269.0 (13.7%) 113.1 (9.7%) 24.1 (8.4%) 35.3 (5.4%) 285.1 (5.3%) 133.9 (11.0%) 1920.0(8.4%)
Other cancers 481.9 (17.3%) 751.8 (8.0%) 263.8 (13.5%) 127.0 (10.9%) 44.1 (15.5%) 49.9 (7.6%) 288.2 (5.4%) 185.1 (15.2%) 2191.8(9.6%)
Secondhand smoke 322.7 (11.6%) 1076.0 (11.5%) 225.0 (11.5%) 135.1 (11.6%) 33.5 (11.7%) 77.2 (11.8%) 628.5 (11.7%) 138.8 (11.4%) 2636.8(11.6%)
Total direct medical cost 2782.5(100%) 9347.4(100%) 1959.0(100%) 1169.6(100%) 285.1(100%) 655.7(100%) 5370.8(100%) 1215.2(100%) 22 785.4(100%)
Proportion of national health expenditure 7.2% 7.8% 9.1% 6.0% 6.5% 7.9% 9.3% 11.7% 8.1%
Productivity cost (US$ millions) =
Premature death
CV disease 170.2 (25.4%) 917.7 (26.4%) 84.3 (19.6%) 48.8 (19.9%) 13.7 (29.3%) 33.8 (28.1%) 387.7 (36.5%) 36.9 (12.0%) 1693.2(26.7%)
Stroke 60.2 (9.0%) 324.8 (9.4%) 42.4 (9.9%) 29.0 (11.8%) 03.4 (7.2%) 15.7 (13.0%) 108.3 (10.2%) 35.2 (11.5%) 619.0(9.7%)
COPD 85.4 (12.8%) 469.8 (13.5%) 91.3 (21.3%) 45.0 (18.4%) 09.7 (20.6%) 20.7 (17.2%) 189.7 (17.8%) 74.5 (24.2%) 986.1(15.5%)
Pneumonia 29.2 (4.4%) 161.7 (4.7%) 08.9 (2.1%) 04.9 (2.0%) 01.6 (3.5%) 07.1 (5.9%) 59.7 (5.6%) 18.3 (5.9%) 291.4(4.6%)
Lung cancer 125.3 (18.7%) 452.2 (13.0%) 63.2 (14.7%) 39.8 (16.3%) 04.4 (9.5%) 08.9 (7.4%) 63.3 (6.0%) 40.1 (13.0%) 797.2(12.5%)
Other cancers 120.2 (18.0%) 739.8 (21.3%) 89.0 (20.7%) 48.4 (19.8%) 08.5 (18.2%) 20.1 (16.7%) 129.2 (12.2%) 67.0 (21.8%) 1222.1(19.2%)
Secondhand smoke 78.7 (11.8%) 405.9 (11.7%) 50.4 (11.7%) 28.8 (11.8%) 05.5 (11.7%) 14.2 (11.8%) 124.9 (11.8%) 35.4 (11.5%) 743.7(11.7%)
Total premature deaths 669.0(100%) 3471.8(100%) 429.6(100%) 244.7(100%) 46.9(100%) 120.4(100%) 1062.9(100%) 307.4(100%) 6352.8(100%)
Disability
CV disease 116.8 (14.6%) 1368.4 (25.1%) 115.0 (15.0%) 28.7 (7.6%) 12.9 (13.1%) 69.3 (29.5%) 350.9 (21.2%) 24.0 (5.6%) 2086.0(21.2%)
Stroke 64.3 (8.0%) 375.0 (6.9%) 100.4 (13.1%) 69.7 (18.3%) 02.6 (2.6%) 26.7 (11.4%) 199.4 (12.0%) 64.6 (15.1%) 902.8(9.2%)
COPD 302.8 (37.8%) 1544.7 (28.3%) 287.9 (37.7%) 163.5 (43.0%) 32.5 (33.0%) 77.9 (33.2%) 598.0 (36.1%) 232.9 (54.4%) 3240.1(33.0%)
Pneumonia 00.3 (0.0%) 00.9 (0.0%) 00.0 (0.0%) 00.0 (0.0%) 00.0 (0.0%) 00.1 (0.0%) 00.5 (0.0%) 00.1 (0.0%) 01.8(0.0%)
Lung cancer 100.8 (12.6%) 547.4 (10.0%) 62.8 (8.2%) 29.5 (7.8%) 12.3 (12.5%) 09.1 (3.9%) 99.9 (6.0%) 18.2 (4.2%) 879.9(9.0%)
Other cancers 122.3 (15.3%) 988.3 (18.1%) 109.2 (14.3%) 44.0 (11.6%) 26.6 (27.0%) 24.3 (10.3%) 214.0 (12.9%) 39.3 (9.2%) 1567.9(16.0%)
Secondhand smoke 93.9 (11.7%) 633.7 (11.6%) 88.9 (11.6%) 44.5 (11.7%) 11.5 (11.7%) 27.7 (11.8%) 195.1 (11.8%) 49.2 (11.5%) 1144.5(11.7%)
Total disability 801.1(100%) 5458.4(100%) 764.1(100%) 379.8(100%) 98.4(100.0%) 235.1(100%) 1657.8(100%) 428.3(100%) 9822.9(100%)
Premature death 669.0 (45.5%) 3471.8 (38.9%) 429.6 (36.0%) 244.7 (39.2%) 46.9 (32.3%) 120.4 (33.9%) 1062.9 (39.1%) 307.4 (41.8%) 6352.8(39.3%)
Disability 801.1 (54.5%) 5458.4 (61.1%) 764.1 (64.0%) 379.8 (60.8%) 98.4 (67.7%) 235.1 (66.1%) 1657.8 (60.9%) 428.3 (58.2%) 9822.9(60.7%)
Total productivity cost 1470.1(100%) 8930.2(100%) 1193.7(100%) 624.6(100%) 145.3(100%) 355.5(100%) 2720.7(100%) 735.8(100%) 16 175.7(100%)
Costs of caregivers (US$ millions)
CV disease 237.2 (22.2%) 2160.5 (35.9%) 252.8 (21.1%) 82.1 (15.8%) 36.6 (36.6%) 91.9 (29.4%) 249.3 (27.0%) 50.6 (7.2%) 3161.1(29.2%)
Stroke 94.8 (8.9%) 530.0 (8.8%) 179.1 (15.0%) 93.3 (18.0%) 03.5 (3.5%) 41.1 (13.2%) 135.9 (14.7%) 115.9 (16.6%) 1193.7(11.0%)
COPD 421.4 (39.4%) 1918.1 (31.8%) 473.7 (39.6%) 228.3 (44.0%) 36.4 (36.4%) 116.9 (37.4%) 359.7 (39.0%) 369.4 (52.8%) 3923.8(36.2%)
Pneumonia 09.9 (0.9%) 39.0 (0.6%) 03.0 (0.2%) 01.2 (0.2%) 00.3 (0.3%) 01.8 (0.6%) 06.0 (0.7%) 07.6 (1.1%) 68.8(0.6%)
Lung cancer 79.4 (7.4%) 224.3 (3.7%) 54.8 (4.6%) 19.9 (3.8%) 03.8 (3.8%) 07.2 (2.3%) 24.3 (2.6%) 23.1 (3.3%) 436.8(4.0%)
Other cancers 102.9 (9.6%) 457.9 (7.6%) 95.9 (8.0%) 34.5 (6.6%) 07.7 (7.7%) 16.6 (5.3%) 39.7 (4.3%) 53.7 (7.7%) 809.0(7.5%)
Secondhand smoke 123.3 (11.5%) 693.8 (11.5%) 136.9 (11.4%) 59.8 (11.5%) 11.7 (11.7%) 36.7 (11.7%) 107.8 (11.7%) 79.8 (11.4%) 1249.7(11.5%)
Total cost of caregivers 1068.9(100%) 6023.7(100%) 1196.3(100%) 519.0(100%) 100.0(100%) 312.2(100%) 922.7(100%) 700.1(100%) 10 843.0(100%)

COPDchronic obstructive pulmonary diseaseCVcardiovascularGDPgross domestic product