The economic cost of tobacco use is a well-studied issue in the context of high-income countries. It has been measured in only a handful of low and middle-income countries (LMICs). This is partly because the tobacco epidemic is at an early stage in LMICs. Hence, the adverse health consequences of tobacco use are not felt as hard as is in high-income countries. This study aims at estimating the economic cost of tobacco use in Uganda. As a benchmark, the study will make tobacco control communities, including professionals and policy makers, aware of the current harms caused by tobacco use to the economy. Consequently, this would lead them to take appropriate measures to prevent the epidemic.
The study used data from four units in the National Referral Hospital namely; Uganda Cancer Institute, Heart Institute, Diabetic and Chest clinic. A sample of 353 patients was surveyed. The study used the World Health Organization (WHO) Economics of Tobacco Toolkit: Assessment of Economic Costs of Smoking, where the Annual Cost option of the “Cost of Illness Approach” was adopted.
The results revealed that the annual average medical cost of a current or former smoker suffering from a tobacco-attributable disease is UGX 3,697,255 (USD 1,422) which is 2.28 times the annualaverage medical cost of a never smoker, that is UGX 1,619,309 (USD 622.8). The relative risk (RR)
ratio is thus 2.28. With a population level tobacco use prevalence of 11.76percent (Global Adult Survey, 2013) and RR of 2.28, the population attributable risk (PAR) is 0.94 percent. It means that about 1percent of the total cost of tobacco-related illnesses can actually be attributed to tobacco use in Uganda. The direct cost of treating tobacco-attributable illnesses in Uganda is estimated to be UGX 108.05 billion (USD 41.56M).
The total health cost of tobacco use including the direct cost of treatment and the indirect costs of loss of income and productivity from death and disability in Uganda is UGX 328.82 billion, which is equivalent to US$126.48 million. The total health cost outweighs the market value UGX 211.15 billion (USD 81.22M) of tobacco products or the assumed benefits of tobacco use in Uganda. These benefits accrue to the wages and salaries of the farmers and employees employed in the tobacco sector, profit of the tobacco growers and manufacturers, and government revenue generated from tobacco taxes. The fact that, the cost of tobacco use in Uganda exceeds the benefits, justifies government intervention to control and combat tobacco use in the country. The cost of tobacco use constituted 0.5 percent of GDP while the health care expenditure for treating tobacco-induced diseases accounted for 2 percent of the national health expenditure in 2013. These resources could have been diverted to more productive uses benefiting public health as well as the economy.