title: The economic benefits of risk factor reduction in Canada: tobacco smoking, excess weight and physical inactivity.
abstract: OBJECTIVE
  Tobacco smoking, excess weight and physical inactivity contribute substantially to the preventable disease burden in Canada. The purpose of this paper is to apply a recently developed approach in addressing the issue of double counting in estimating the combined current economic burden of these risk factors (RFs) and to estimate the economic benefits of long-term RF reduction in Canada.
  
  
  METHODS
  We used an approach based on population attributable fractions (PAF) to estimate the economic burden associated with the various RFs. Sex-specific relative risk and age-/sex-specific prevalence data were used in the modelling when available. Excess weight was modelled as a trichotomous exposure (normal weight, overweight, obese) while tobacco smoking was modelled as a tetrachotomous exposure (non-smoker, light, medium or heavy smoker). All costs are given in constant 2012 Canadian dollars.
  
  
  RESULTS
  The annual economic burden of the RFs of tobacco smoking, excess weight and physical inactivity in Canada are estimated at $50.3 billion in 2012. Sensitivity analysis suggests a range for the economic burden of $41.6 to $58.7 billion. Of the $50.3 billion, $21.3 ($20.0 to $22.6) billion is attributable to tobacco smoking, $19.0 ($13.8 to $24.0) billion to excess weight and $10.0 ($7.8 to $12.0) billion to physical inactivity. A 1% relative annual reduction in each of the three RFs would result in an $8.5 billion annual reduction in economic burden by 2031.
  
  
  CONCLUSIONS
  A modest annual 1% relative reduction in the RFs of tobacco smoking, excess weight and physical inactivity can have a substantial health and economic impact over time at the population level.
authors.affiliation: School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada H. Krueger & Associates Inc., Delta, British Columbia, Canada. hans@krueger.ca.
authors.forename: Hans
authors.initials: H
authors.lastname: Krueger
authors.forename: Donna
authors.initials: D
authors.lastname: Turner
authors.forename: Joshua
authors.initials: J
authors.lastname: Krueger
authors.forename: A Elizabeth
authors.initials: AE
authors.lastname: Ready
mesh_terms: D002170:Canada / Q000453:epidemiology; D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D008297:Male; D018803:Models, Economic; D009765:Obesity / Q000191:economics* / Q000453:epidemiology / Q000517:prevention & control; D012307:Risk Factors; D040242:Risk Reduction Behavior; D057185:Sedentary Behavior; D012907:Smoking / Q000191:economics* / Q000453:epidemiology; D000074606:Smoking Prevention
keywords: economic burden; excess weight; physical inactivity; population attributable fraction; risk factors; tobacco smoking
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