Tobacco's financial burden to social security systems: exploration of smoking-attributable sick leave payments in Colombia

Abstract

Background Smoking is an important risk factor of disease and economic burden. Within the latter, a less explored component is sick leave due to non-occupational disease (SLNOD) attributable to smoking. Objective This study estimates the average annual smokig-attributable SLNOD financial costs from the social security system perspective in Colombia using data from 2016 to 2018. Methods An annual prevalence study, specific by sex-age-disease was used to estimate smoking-attributable SLNOD financial costs. Attributable fractions from the Global Burden of Disease Study were applied to select the number of smoking-attributable SLNOD cases. SLNOD financial costs were obtained from the Ministry of Health and Social Protection sick leave registry. Results The average annual smoking-attributable SLNOD financial cost was estimated at 1.59 million USD (95% CI:1.13; 2.2). Men (1.28 million USD; CI95%: 0.96; 1.69), 55 to 59 age group (0.40 million USD; CI95%: 0.30; 0.52) and ischemic heart disease (0.59 million USD; CI95%: 0.48; 0.73) contribute the most to the smoking attributable costs. Conclusion This study on the SLNOD financial cost attributable to smoking provides relevant insights for key actors of the social security system on the expenses that could potentially be avoided with effective tobacco prevention interventions.