The costs of alcohol, illegal drugs, and tobacco in Canada, 2002.
OBJECTIVE
The aim of this study was to estimate costs attributable to substance use and misuse in Canada in 2002.


METHODS
Based on information about prevalence of exposure and risk relations for more than 80 disease categories, deaths, years of life lost, and hospitalizations attributable to substance use and misuse were estimated. In addition, substance-attributable fractions for criminal justice expenditures were derived. Indirect costs were estimated using a modified human capital approach.


RESULTS
Costs of substance use and misuse totaled almost Can. $40 billion in 2002. The total cost per capita for substance use and misuse was about Can. $1,267: Can. $463 for alcohol, Can. $262 for illegal drugs, and Can. $541 for tobacco. Legal substances accounted for the vast majority of these costs (tobacco: almost 43% of total costs; alcohol: 37%). Indirect costs or productivity losses were the largest cost category (61%), followed by health care (22%) and law enforcement costs (14%). More than 40,000 people died in Canada in 2002 because of substance use and misuse: 37,209 deaths were attributable to tobacco, 4,258 were attributable to alcohol, and 1,695 were attributable to illegal drugs. A total of about 3.8 million hospital days were attributable to substance use and misuse, again mainly to tobacco.


CONCLUSIONS
Substance use and misuse imposes a considerable economic toll on Canadian society and requires more preventive efforts.
Rehm
Jürgen
J
Centre for Addiction and Mental Health, 33 Russell Street, Room 2035B, Toronto, Ontario M5S 2S1, Canada. jtrehm@aol.com
Gnam
William
W
Popova
Svetlana
S
Baliunas
Dolly
D
Brochu
Serge
S
Fischer
Benedikt
B
Patra
Jayadeep
J
Sarnocinska-Hart
Anna
A
Taylor
Benjamin
B
D000437:Alcoholism / Q000191:economics*; D002170:Canada / Q000453:epidemiology; D017281:Cost of Illness; D003415:Crime; D005260:Female; D006801:Humans; D008297:Male; D002189:Marijuana Abuse / Q000191:economics; D012907:Smoking / Q000191:economics*; D019966:Substance-Related Disorders / Q000191:economics*; D013997:Time Factors