title: Health care costs and work absenteeism in smokers: study in an urban community.
abstract: BACKGROUND
  Higher morbidity caused by smoking-related diseases could increase health costs. We analyzed differences in the use of healthcare resources, healthcare costs and days of work absenteeism among smokers and non-smokers.
  
  
  METHODS
  Cross-sectional study in smokers and non-smokers, aged between 45 and 74 years, from one urban health area. The variables studied were: age, sex, alcohol intake, physical activity, obesity, diseases, attendance at primary care clinics and hospital emergency rooms, days of hospitalization, prescription drug consumption and work absenteeism (in days). Annual cost according to the unit cost of each service (direct costs), and indirect costs according to the number of days missed from work was calculated. Crude and adjusted risks were calculated using logistic regression.
  
  
  RESULTS
  Five hundred patients were included: 50% were smokers, 74% (372) men and 26% (128) women. Smokers used more healthcare resources, consumed more prescription drugs and had more days off work than non-smokers. Respective direct and indirect costs in smokers were 848.64 euros (IQ 25-75: 332.65-1517.10) and 2253.90 euros (IQ 25-75: 1024.50-13113.60), and in non-smokers were 474.71 euros (IQ 25-75: 172.88-979.59) and 1434.30 euros (IQ 25-75: 614.70-4712.70). The likelihood of generating high healthcare costs was more than double for smokers (OR=2.14; 95% CI: 1.44-3.19).
  
  
  CONCLUSIONS
  More investment in programs for the prevention and treatment of smoking, as a health policy priority, could help to reduce the health and social costs of smoking.
authors.affiliation: Centro de Salud Mosqueruela, Mosqueruela, Teruel, España.
authors.forename: María Pilar
authors.initials: MP
authors.lastname: Suárez-Bonel
authors.affiliation: Centro de Salud Cariñena, Cariñena, Zaragoza, España; Facultad de Ciencias de la Salud, Universidad San Jorge, Zaragoza, España.
authors.forename: María Victoria
authors.initials: MV
authors.lastname: Villaverde-Royo
authors.affiliation: Unidad de Tabaquismo FMZ, Departamento de Medicina y Psiquiatría, Facultad de Medicina, Universidad de Zaragoza, Zaragoza, España. Electronic address: isabelne@unizar.es.
authors.forename: Isabel
authors.initials: I
authors.lastname: Nerín
authors.affiliation: Centro de Salud Bombarda, Zaragoza, España; Facultad de Medicina, Universidad de Zaragoza, Zaragoza, España.
authors.forename: Concepción
authors.initials: C
authors.lastname: Sanz-Andrés
authors.affiliation: Centro de Salud Delicias Sur, Zaragoza, España.
authors.forename: Julia
authors.initials: J
authors.lastname: Mezquida-Arno
authors.affiliation: Facultad de Medicina, Universidad de Zaragoza, Zaragoza, España; Centro de Salud Delicias Sur, Zaragoza, España.
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Córdoba-García
mesh_terms: D000041:Absenteeism; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D017048:Health Care Costs; D006295:Health Resources / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012907:Smoking / Q000191:economics*; D013030:Spain; D014504:Urban Health
keywords: Absenteeism; Absentismo; Costos y análisis de costo; Costs and cost analysis; Smoking; Tabaquismo