title: Direct and indirect costs of smoking in Vietnam.
abstract: OBJECTIVE
  To estimate the direct and indirect costs of active smoking in Vietnam.
  
  
  METHODS
  A prevalence-based disease-specific cost of illness approach was utilised to calculate the costs related to five smoking-related diseases: lung cancer, cancers of the upper aerodigestive tract, chronic obstructive pulmonary disease, ischaemic heart disease and stroke. Data on healthcare came from an original survey, hospital records and official government statistics. Morbidity and mortality due to smoking combined with the average per capita income were used to calculate the indirect costs of smoking by applying the human capital approach. The smoking-attributable fraction was calculated using the adjusted relative risk values from phase II of the American Cancer Society Cancer Prevention Study (CPS-II). Costs were classified as personal, governmental and health insurance costs.
  
  
  RESULTS
  The total economic cost of smoking in 2011 was estimated at 24 679.9 billion Vietnamese dong (VND), equivalent to US$1173.2 million or approximately 0.97% of the 2011 gross domestic product. The direct costs of inpatient and outpatient care reached 9896.2 billion VND (US$470.4 million) and 2567.2 billion VND (US$122.0 million), respectively. The government's contribution to these costs was 4534.3 billion VND (US$215.5 million), which was equivalent to 5.76% of its 2011 healthcare budget. The indirect costs (productivity loss) due to morbidity and mortality were 2652.9 billion VND (US$126.1 million) and 9563.5 billion VND (US$454.6 million), respectively. These indirect costs represent about 49.5% of the total costs of smoking.
  
  
  CONCLUSIONS
  Tobacco consumption has large negative consequences on the Vietnamese economy.
authors.affiliation: HealthBridge Foundation of Canada, Hanoi, Vietnam.
authors.forename: Pham Thi
authors.initials: PT
authors.lastname: Hoang Anh
authors.affiliation: HealthBridge Foundation of Canada, Hanoi, Vietnam.
authors.forename: Le Thi
authors.initials: le T
authors.lastname: Thu
authors.affiliation: SALDRU Research Affiliate, University of Cape Town, Cape Town, South Africa International Clinical Research Center Research Affiliate, St. Anne's University Hospital, Brno, Czech Republic.
authors.forename: Hana
authors.initials: H
authors.lastname: Ross
authors.affiliation: Department of Health Economics, Hanoi School of Public Health, Hanoi, Vietnam.
authors.forename: Nguyen
authors.initials: N
authors.lastname: Quynh Anh
authors.affiliation: Department of Health Economics, Hanoi School of Public Health, Hanoi, Vietnam.
authors.forename: Bui Ngoc
authors.initials: BN
authors.lastname: Linh
authors.affiliation: Department of Economics, University of Illinois at Chicago, Chicago, Illinois, USA.
authors.forename: Nguyen Thac
authors.initials: NT
authors.lastname: Minh
mesh_terms: D017281:Cost of Illness; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012907:Smoking / Q000191:economics*; D014744:Vietnam
keywords: Economics; Low/Middle income country; Smoking Caused Disease