Background:
Tobacco use causes acute and chronic diseases such as acute myocardial infarction (ICD-10: I21), cerebrovascular diseases (ICD-10: I60-I69), lung cancer (ICD-10: C34) and chronic obstructive pulmonary disease (ICD-10: J40-J44) that lead to direct and indirect costs. The latter include lost productivity due to premature death and absenteeism, among others. The objective of this study was to estimate lost productivity attributable to tobacco by premature death and absenteeism caused by hospitalizations.

Methods:
I used mortality microdata published by the National Institute of Statistics and Geography and hospital discharge microdata by the Directorate General of Health Information for 2014. In order to estimate productivity, I used the National Occupation and Employment Survey for 2014. Productivity was estimated using the human capital approach, calculating the expected wage by sex, age, region and quarter. Productivity loss by premature death was calculated as the sum of discounted future flows of wages until expected age of death in persons that died by the diseases of interest defined above. Productivity loss by absenteeism was calculated as the product of days at hospital and mean wage, according to sex, age, region and quarter. Population Attributable Fractions from previous literature for Mexico were used to estimate the costs attributable to tobacco.

Results:
I estimated a total of 2859.49 million USD productivity loss by premature death and 7.56 million USD by absenteeism caused by hospitalization in 2014.

Conclusions:
In addition to medical expenditures, tobacco use causes enormous productivity loss. These results do not include productivity loss by absenteeism caused by doctor visits or presenteeism, which can be much larger.