title: Costs of medical care for acute myocardial infarction attributable to tobacco consumption.
abstract: BACKGROUND
  Tobacco consumption is the principal modifiable risk factor causally associated with acute myocardial infarction (AMI). AMI has been an increasing and important cause of death in Mexico since 1980.
  
  
  METHODS
  To estimate the direct health care costs of AMI, we carried out a cost of illness (COI) analysis, using data derived from an expert panel consensus and from medical chart review. We used the smoking attributable fraction (SAF) estimates to derive costs of tobacco consumption. We also estimated the benefits of a "Smoke-free Workplace" tobacco control policy in terms of avoidable deaths and health care costs savings.
  
  
  RESULTS
  We estimated an annual average costs of 6,420 US dollars and 9,216 US dollars for non-ST segment elevation AMI (NSTEMI) and ST segment elevation AMI (STEMI), respectively. The total annual health care costs estimated for incident AMI for the IMSS state-level division of Morelos reached 2.9 million US dollars, of which 1.6 million US dollars was directly attributed to tobacco consumption.
  
  
  CONCLUSIONS
  Our results confirm the high costs associated with smoking and show the potential benefits resulting from a tobacco control policy. Our estimates are only applicable to social security in the state-level division of Morelos and more likely represent a lower boundary of the total costs of cardiovascular diseases attributed to tobacco, because we based the costs estimation on incident cases, and we did not take into consideration the costs derived from prevalent cases, indirect costs or other intangibles.
authors.affiliation: Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México.
authors.forename: Luz Myriam
authors.initials: LM
authors.lastname: Reynales-Shigematsu
authors.forename: Julio César
authors.initials: JC
authors.lastname: Campuzano-Rincón
authors.forename: Sergio
authors.initials: S
authors.lastname: Sesma-Vásquez
authors.forename: Sergio Arturo
authors.initials: SA
authors.lastname: Juárez-Márquez
authors.forename: Raydel
authors.initials: R
authors.lastname: Valdés-Salgado
authors.forename: Eduardo
authors.initials: E
authors.lastname: Lazcano-Ponce
authors.forename: Mauricio
authors.initials: M
authors.lastname: Hernández-Avila
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D003365:Costs and Cost Analysis; D005260:Female; D017048:Health Care Costs; D006801:Humans; D008297:Male; D008800:Mexico; D008875:Middle Aged; D009203:Myocardial Infarction / Q000191:economics* / Q000209:etiology* / Q000628:therapy; D012907:Smoking