The social cost of alcohol, tobacco and illicit drugs in France, 1997.
AIM, DESIGN AND SETTING: The economic costs of alcohol, tobacco and illicit drugs to French society are estimated using a cost of illness framework.


METHODS
For the cause of disease or death (using ICD-9 categories), pooled relative risk estimates from meta-analyses were combined with prevalence data by age and gender to derive the proportion attributable to alcohol, tobacco and/or illicit drugs. The resulting estimates of attributable deaths and hospitalizations were used to calculate the associated health care, law enforcement, productivity and other costs. The results were compared with those of other studies, and sensitivity analyses were conducted by alternative ways of measuring risk attribution and costs.


RESULTS
The use of alcohol, tobacco and illicit drugs cost more than 200 billion francs (FF) in France in 1997, representing 3714 FF per capita or 2.7% of the gross domestic product (GDP). Alcohol is the drug that gives rise to the greatest cost in France, i.e. 115420.91 million FF (1.42% of GDP) or an expenditure per capita of 1966 FF in 1997. Alcohol takes more than half of the social cost of drugs to society. The greatest share of the social cost of alcohol comes from the loss of productivity (57555.66 million FF), due to premature death (53168.60 million FF), morbidity (3884.0 million FF) and imprisonment (503.06 million FF). Tobacco leads to a social cost of 89256.90 million FF, that is an expenditure per capita of 1520.56 FF or 1.1% of GDP. Productivity losses amount to 50446.70 million FF, with losses of 42765.80 million FF as a result of premature death and 7680.90 million FF linked to morbidity. Health care costs for tobacco occupy second place at 26973.70 million FF. Illicit drugs generate a social cost of 13350.28 million FF, that is an expenditure per capita of 227.43 FF or 0.16% of GDP. Productivity losses reach 6099.19 million FF, with 5246.92 million FF linked to imprisonment and 852.27 million FF to premature death. The cost of enforcing the law for illicit drugs occupies second place at 3911.46 million FF, followed by health care costs of 1524.51 million FF.


CONCLUSIONS
Substance abuse exact a considerable toll from French society in terms of illness, injury, death and economic costs.
Fenoglio
Philippe
P
Université Nancy 2, Nancy, France.
Parel
Véronique
V
Kopp
Pierre
P
D000428:Alcohol Drinking / Q000191:economics* / Q000401:mortality*; D017281:Cost of Illness; D003365:Costs and Cost Analysis; D005260:Female; D005602:France / Q000453:epidemiology; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D013287:Illicit Drugs / Q000191:economics; D008297:Male; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders / Q000191:economics / Q000401:mortality; D014029:Tobacco Use Disorder / Q000191:economics* / Q000401:mortality*
D013287:Illicit Drugs