The Costs of Tobacco Use Are Not Simply Financial

The costs to society of tobacco smoking occur at 3 levels:
1) Direct financial costs: these include costs to patients and healthcare systems: doctor visits and prescriptions, surgeries and other procedures, chemotherapy for cancer, for example.
2) Indirect financial costs: These include, among others, financial losses to businesses due to individuals taking time off work for tobacco-related sickness, costs of healthcare for passive smokers, costs of fires caused by cigarettes.
3) Intangible costs: Examples of these are non-financial issues such as pain and suffering of victims and their relatives and friends, loss of life, reduced quality of life, costs of the loss of a normal childhood and education in child labourers who work for the tobacco industry in many countries.

There is a frequent tendency in academic, governmental and public documents and articles to talk about the costs of human disease in financial terms. Diabetes costs this much money, heart disease costs that many millions of dollars. But the real costs of disease and human suffering are much more than financial. How can we put a dollar price on the most important human issues of all: physical pain, loss of health and life, and emotional and psychological suffering?

Therefore, those intangible costs of smoking are where our main focus should be and there is no monetary value that can be attached to them.

Having said this, what are the benefits of tobacco production and use to human beings? There are tax revenues from the sales of tobacco, profits for the tobacco companies (especially for their executives and shareholders), wages and employment for others who work in the tobacco industry, immediate benefits that smokers get from smoking (feeling calm, relief from withdrawal, social relaxation, for example). Some people might argue that there is also reduction in pension costs because tobacco kills many people before they reach retirement age, though obviously this is a dubious benefit.

A breakdown of costs of smoking to society in the United Kingdom in 2010 found that the yearly financial costs of smoking were 13 billion pounds sterling, of which National Health System costs were 2.8 billion pounds; 5.4 billion pounds were due to workers being off work because of smoking-related illness and workers taking “smoking breaks;” 4.1 billion pounds were due to loss of workforce productivity because of tobacco-related deaths. It’s worth mentioning that the estimated yearly cost of cleaning up tobacco-related litter such as butts and empty cigarette packs was over 300 million pounds.

But how can we analyse the costs to human misery of smoking? Really, we cannot. Every child who suffers daily, labouring in tobacco fields; every adult who dies miserably from lung cancer; every baby who becomes ill from a parent who smokes around them; every victim who is scarred from fires or burns caused by cigarettes; every person who has lost a loved one from a tobacco-related disease- each and every one of them is precious and not even all the money on Earth can replace their suffering.

Ekpu VU, Brown AK. The Economic Impact of Smoking and of Reducing Smoking Prevalence: Review of Evidence. Tobacco Use Insights 2015; 8:1-35. Published online 2015 Jul 14. doi:  10.4137/TUI.S15628 

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