BACKGROUND: Tobacco use imposes a significant health burden and costs globally, particularly in low- and middle-income countries (LMICs). This study assesses the disease burden, direct medical and societal costs associated with tobacco use, and the potential effects of fully implementing key tobacco control measures in Bolivia, Honduras, Nigeria, Paraguay, and Uruguay.
METHODS: A Markov probabilistic microsimulation model was developed to project the natural history, associated costs, and quality-of-life impacts of major tobacco-related diseases. The model was parameterized using epidemiological and economic data from 2023, derived from systematic reviews, national surveys, civil registries, and hospital databases. The effectiveness of the interventions was estimated based on evidence from global and regional evidence synthesis considering the results accumulated over 10 years.
RESULTS: In 2023, smoking in these five countries accounts for approximately 41.000 deaths, 360.000 disease events, 1.3 million years of healthy life lost, US$ 2.8 billion in direct medical costs, US$ 933 million in lost productivity, and US$ 590 million in informal caregiver costs—representing a total of 0.7% of their aggregated GDP. The full implementation and enforcement of the four strategies (50% increase in tobacco prices through taxation, plain packaging, advertising bans, and smoke-free environments) would avert 53.000, 77.000, 95.000, and 8.700 deaths over the next decade, respectively. These measures are projected to save between US$ 1.3 and US$ 2 billion and an increase in tax collection of US$ 1.502 billion.
CONCLUSIONS: The findings highlight the significant potential of targeted tobacco control interventions to reduce the disease burden and associated healthcare costs in diverse populations. Policymakers and stakeholders must leverage data-driven insights to refine existing programs and allocate resources efficiently, ultimately advancing global efforts to mitigate the health and economic consequences of tobacco use.