[Smoking-attributable productivity loss in Germany--a partial sickness cost study based on the human capital potential method].
OBJECTIVE
Costs of productivity loss for the Federal Republic of Germany attributable to smoking in 1999 was to be determined.


METHODS
Mortality and morbidity attributable to smoking is determined by a 0.5 % sample of the smoking behaviour of the German population (microcensus 1999) and the relative mortality risks of smokers (US-American cancer prevention study II). Tobacco smoke-associated cancer illnesses, cardiovascular diseases, respiratory tract diseases and illnesses of children under one year are considered. Calculation of the productivity-relevant consequences of smoking due to morbidity and mortality is effected according to the so-called human potential capital method.


RESULTS
In Germany total of 607,393 working years were lost because of smoking in the year 1999. The costs of productivity loss are estimated at 14,480 billion euro. From this 4,525 billion euro are allotted to premature mortality, 5.759 billion euro to permanent disablement and 4.196 billion euro to temporary incapacitation for work. If the costs of productivity loss by smoking are referred to the gross national product (BSP) in the year 1999, an economical damage at a value of 0.74 % of BSPs results. This corresponds to a productivity loss of 379 euro per present or former smoker. The sensitivity analysis manifests that the inclusion of "non-marketable production" results in an immense rise productivity losses attributable to smoking. However, it should be noted that in times of mass unemployment the human capital method which is based on full employment does not measure the actual, but only the potential productivity loss cost.


CONCLUSIONS
This partial disease cost study shows that immense economic productivity losses are associated with smoking. This loss of resources can justify a purposeful promotion of studies regarding cost effectiveness of anti-smoking therapeutic measures or preventive measures against smoking. But it should be considered that the use of the human potential capital method results in an overestimation of the actual productivity losses by smoking. In future the costs of productivity losses attributable to smoking should be determined by the friction cost method. With this procedure a more realistic estimation of productivity-relevant costs of smoking is possible.
Lehrstuhl für Allgemeine Betriebswirtschaftslehre und Gesundheitsmanagement, Ernst-Moritz-Arndt Universität Greifswald. chwegner@uni-greifswald.de
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D000328:Adult; D017677:Age Distribution; D000368:Aged; D002201:Capital Expenditures / Q000706:statistics & numerical data; D017281:Cost of Illness; D003365:Costs and Cost Analysis / Q000379:methods*; D004526:Efficiency; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007182:Income / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D017059:Models, Econometric; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D017678:Sex Distribution; D012907:Smoking / Q000191:economics* / Q000401:mortality* / Q000639:trends; D026712:Value of Life / Q000191:economics