BACKGROUND: The global economic burden of the tobacco epidemic is significant, reaching 1.8% of Gross Domestic Product (Goodchild et al. 2018). In Mexico, simulation models following hypothetical population cohorts indicate that tobacco-attributable social costs (direct and indirect) reach MX$ 194.6 billion (US$ 8.5) annually (Saenz-de-Miera et al. 2024). Drawing on temporary sick leave (TSL) certificates, this study aims to provide further evidence on tobacco-attributable indirect costs from the perspective of the Mexican Social Security Institute (IMSS), which covers formal sector workers.
METHODS: Anonymized administrative records from IMSS (2010-2022) on non-occupational TSL for the main diseases associated with tobacco use —acute myocardial infarction (AMI), cerebrovascular disease (CVD), chronic obstructive pulmonary disease (COPD), diabetes, lung cancer, and mental illnesses— were analyzed. Productivity loss was calculated using the human capital approach and population attributable fractions. In addition, financial costs for IMSS were estimated based on subsidies granted (60% of salaries after the third day of TSL). Monetary figures are in 2023 Mexican pesos (2023MX$).
RESULTS: Between 2010 and 2022, TSL due to the diseases of interest averaged 32.546 per year, with 29.5% attributable to tobacco. The annual average tobacco-attributable productivity loss was 2023MX$ 146.0 million. In 2022, this figure reached 2023MX$ 196.9 million (95% CI: 190.7-203.1), distributed as follows: 124.4 (95% CI: 119.2-129.6) for CVD, 20.0 (95% CI: 17.8-22.5) for diabetes, 17.6 (95% CI: 16.2-18.8) for AMI, 14.6 (95% CI: 13.5-15.6) for COPD, 11.0 (95% CI: 9.6-12.3) for lung cancer, and 9.3 (95% CI: 7.8-10.8) for mental illnesses. The average annual tobacco-attributable financial cost for IMSS was 2023MX$ 84.2 million; 2023MX$ 113.1 million (95% CI: 108.8-117.3) in 2022.
CONCLUSIONS: Tobacco use imposes a notable economic burden through productivity loss and financial costs for IMSS. These expenses could be significantly reduced with effective prevention and cessation interventions specially designed for workers affiliated with IMSS.