Tobacco Causes Trillions in Healthcare Expenditures, Productivity Losses

New WHO report warns of harms related to tobacco use.

Tobacco use has been known to cause cancer for decades, but many individuals around the world continue to use the substance. This can lead to serious adverse events, including death from tobacco-related disease.

A new report from the World Health Organization (WHO) outlines how taking action against tobacco use can improve global health, economy, and environment. The WHO is calling on governments to implement stronger tobacco control measures.

Each year, tobacco use results in more than 7 million deaths around the world and costs $1.4 trillion in healthcare expenditures and lost productivity, according to the report. These significant costs are largely preventable.

"Tobacco threatens us all. Tobacco exacerbates poverty, reduces economic productivity, contributes to poor household food choices, and pollutes indoor air,” said Margaret Chan, MD, WHO director-general. "But by taking robust tobacco control measures, governments can safeguard their countries' futures by protecting tobacco users and non-users from these deadly products, generating revenues to fund health and other social services, and saving their environments from the ravages tobacco causes."

All countries have committed to the 2030 Agenda for Sustainable Development, which includes controlling tobacco use. The goal of the agenda is to prevent one-third of premature deaths from noncommunicable diseases by 2030. These deaths include conditions where tobacco use is a risk factor, including heart disease, lung disease, cancer, and diabetes, according to the study. Overall, tobacco plays a role in more than 16% of noncommunicable diseases.

The WHO reports that waste from tobacco production leaks more than 700 toxic chemicals into the environment, with many known to be carcinogenic to humans. Additionally, tobacco smoke contributes to the spread of human carcinogens.

Tobacco use also affects the health and well-being of low- and middle-income families. Numerous studies have shown that tobacco products account for more than 10% of expenditures, which leaves less money for food and healthcare, according to the report.

"Many governments are taking action against tobacco, from banning advertising and marketing, to introducing plain packaging for tobacco products, and smoke-free work and public places," said Oleg Chestnov, MD, WHO's assistant director-general for Noncommunicable Diseases and Mental Health. "But one of the least used, but most effective, tobacco control measures to help countries address development needs is through increasing tobacco tax and prices."

Tobacco-related illness kills millions around the world annually and represents a significant public health concern; however, it is one of the most modifiable risk factors, according to the report.

The authors suggest that reducing exposure to smoke, banning advertising and sales to minors, and requiring health warnings on tobacco packaging would reduce the adverse effects of tobacco. Additionally, countries should encourage tobacco cessation, increase tobacco taxes, and create a national approach to tobacco control, according to the report.

While many of these initiatives are already in place in the United States, many developed and developing countries have yet to take significant steps to reduce the burden of tobacco on patients and the healthcare system.

"Tobacco is a major barrier to development globally. Tobacco-related death and illness are drivers of poverty, leaving households without breadwinners, diverting limited household resources to purchase tobacco products rather than food and school materials, and forcing many people to pay for medical expenses,” said Douglas Bettcher, MD, director of WHO’s Department for the Prevention on Noncommunicable Diseases. "But action to control it will provide countries with a powerful tool to protect their citizens and futures."