ArticleBMC health services research2013
The association of smoking status with healthcare utilisation, productivity loss and resulting costs: results from the population-based KORA F4 study.
Article in BMC health services research, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 1 of them a synthesis that pooled it.
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Who cites it
35 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Economic Burden of Self-Reported Tobacco Smoking Compared with Non-Smoking: Systematic Review and Meta-Analysis of Direct Health Care Costs.Advances in therapy · 2025Pooled it
- Predicting total healthcare demand using machine learning: separate and combined analysis of predisposing, enabling, and need factors.BMC health services research · 2025Article
- Modeling the determinants of smoking behavior among young adults in Khuzestan province: a two-level count regression approach.Frontiers in public health · 2024Article
- The Impact of Smokers' Information-Seeking Behavior on Smoking Cessation.Advances in experimental medicine and biology · 2023Article
- The relative impact of underweight, overweight, smoking, and physical inactivity on health and associated costs in Indonesia: propensity score matching of a national sample.BMC health services research · 2022Article
- Utilisation of supplementary prenatal screening and diagnostics in Germany: cross-sectional study using data from the KUNO Kids Health Study.BMC pregnancy and childbirth · 2022Article
- Impact of Tobacco Smoking on Health Care Utilization and Medical Costs in Chronic Obstructive Pulmonary Disease, Coronary Heart Disease and Diabetes.Current medical science · 2022Article
- Characteristics and determinants of loss to follow-up among tuberculosis (TB) patients who smoke in an industrial state of Malaysia: a registry-based study of the years 2013-2017.BMC public health · 2022Article
- Associations of At-Risk Drinking, Current Smoking, and Their Co-Occurrence With Primary Care Service Utilization.American journal of health promotion : AJHP · 2022Article
- The impact of current smoking, regular drinking, and physical inactivity on health care-seeking behavior in China.BMC health services research · 2022Article
- The effects of smoking, regular drinking, and unhealthy weight on health care utilization in China.BMC public health · 2021Article
- Patient-specific factors associated with use of diabetes self-management education and support programs in Louisiana.BMJ open diabetes research & care · 2021Article
- The utilization of specialized healthcare services among frail older adults in the Helsinki Birth Cohort Study.Annals of medicine · 2021Article
- Cigarette Smoking and Estrogen-Related Cancer.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2021Review
- Trends in equity of inpatient health service utilization for the middle-aged and elderly in China: based on longitudinal data from 2011 to 2018.BMC public health · 2021Article
- Socioeconomic and Lifestyle Factors Related to Cost and Frequency of Hospitalization in European Older Adults.International journal of environmental research and public health · 2021Article
- Critical appraisal of the European Union Scientific Committee on Health, Environmental and Emerging Risks (SCHEER) Preliminary Opinion on electronic cigarettes.Harm reduction journal · 2021Review
- Mammography use in relation to comorbidities and functional limitations among older breast cancer survivors.Journal of cancer survivorship : research and practice · 2021Article
- Factors Influencing the Length of Hospital Stay Among Patients with Chronic Obstructive Pulmonary Disease (COPD) in Macao Population: A Retrospective Study of Inpatient Health Record.International journal of chronic obstructive pulmonary disease · 2021Article
- Association of smoking with direct medical expenditures of chronic diseases in north of Jordan: a retrospective cohort study.BMJ open · 2019Article
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSmoking is seen as the most important single risk to health today, and is responsible for a high financial burden on healthcare systems and society. This population-based cross-sectional study compares healthcare utilisation, direct medical costs, and costs of productivity losses for different smoking groups: current smokers, former smokers, and never smokers.
methodsUsing a bottom-up approach, data were taken from the German KORA F4 study (2006/2008) on self-reported healthcare utilisation and work absence due to illness for 3,071 adults aged 32-81 years. Unit costs from a societal perspective were applied to utilisation. Utilisation and resulting costs were compared across different smoking groups using generalised linear models to adjust for age, sex, education, alcohol consumption and physical activity.
resultsAverage annual total costs per survey participant were estimated as €3,844 [95% confidence interval: 3,447-4,233], and differed considerably between smoking groups with never smokers showing €3,237 [2,802-3,735] and former smokers causing €4,398 [3,796-5,058]. There was a positive effect of current and former smoking on the utilisation of healthcare services and on direct and indirect costs. Total annual costs were more than 20% higher (p<0.05) for current smokers and 35% higher (p<0.01) for former smokers compared with never smokers, which corresponds to annual excess costs of €743 and €1,108 per current and former smoker, respectively.
conclusionsResults indicate that excess costs for current and former smokers impose a large burden on society, and that previous top-down cost approaches produced lower estimates for the costs of care for smoking-related diseases. Efforts must be focused on prevention of smoking to achieve sustainable containment on behalf of the public interest.
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