{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T01:52:49Z","timestamp":1780710769711,"version":"3.54.1"},"reference-count":33,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2025,1,23]],"date-time":"2025-01-23T00:00:00Z","timestamp":1737590400000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002749","name":"Belgian Federal Science Policy Office","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002749","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002749","name":"BELSPO","doi-asserted-by":"publisher","award":["DR\/94\/SUBOD"],"award-info":[{"award-number":["DR\/94\/SUBOD"]}],"id":[{"id":"10.13039\/501100002749","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,2,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Tobacco use is among the leading behavioural risk factors for morbidity and mortality. These high rates result in a high cost to society. Therefore, the aim of the current study was to provide a contemporary overview of the direct medical and indirect costs attributable to smoking tobacco in Belgium. Data from the Belgian Health Interview Survey (BHIS) was combined with health insurance claims data. Healthcare costs were calculated on individuals\u2019 cigarette smoking patterns (daily, former, and never smokers). Lost productivity costs were calculated by multiplying the number of absence days by the national average wage cost per day. Univariate and multivariable regression analyses with negative binomial distribution and log link were performed to evaluate the average healthcare costs and indirect costs in relation to tobacco use, socio-demographic characteristics, and (behavioural) risk factors. A total of 10\u00a0829 individuals were included in the analyses, of which 47.7% were men, with 15% being smokers. Men were more likely to be smokers than women (56.8% vs. 43.2%; P\u2009&amp;lt;\u20090.001). Compared to never smokers, significantly higher direct medical costs were found for daily (20%; P\u2009=\u20090.03) and former smokers (27%; P\u2009&amp;lt;\u20090.001). No significant differences were observed for the indirect costs for the smoking population compared to never smokers. Taking into account that 15% of the Belgian population were daily smokers in 2018, the national cost for daily smokers equates to \u20ac533.861.010. Results of our study show that cigarette smoking has higher direct medical costs compared with never smokers.<\/jats:p>","DOI":"10.1093\/eurpub\/ckae211","type":"journal-article","created":{"date-parts":[[2025,1,23]],"date-time":"2025-01-23T07:40:17Z","timestamp":1737618017000},"page":"108-113","source":"Crossref","is-referenced-by-count":3,"title":["The economic burden of smoking in Belgium: incremental healthcare costs and lost productivity"],"prefix":"10.1093","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8410-6328","authenticated-orcid":false,"given":"Pieter","family":"Vynckier","sequence":"first","affiliation":[{"name":"Department of Public Health and Primary Care, Ghent University , Ghent,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masja","family":"Schmidt","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Public Health, Sciensano , Brussels,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Nayani","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Public Health, Sciensano , Brussels,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonor","family":"Guariguata","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Public Health, Sciensano , Brussels,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brecht","family":"Devleesschauwer","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Public Health, Sciensano , Brussels,","place":["Belgium"]},{"name":"Department of Translational Physiology, Infectiology and Public Health, Ghent University\u2014Campus Merelbeke , Merelbeke,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nick","family":"Verhaeghe","sequence":"additional","affiliation":[{"name":"Department of Public Health and Primary Care, Ghent University , Ghent,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,1,22]]},"reference":[{"key":"2025021721441806400_ckae211-B1","author":"World Health Organization","year":"2019"},{"key":"2025021721441806400_ckae211-B2","author":"World Health Organization","year":"2023"},{"key":"2025021721441806400_ckae211-B3","doi-asserted-by":"crossref","first-page":"2337","DOI":"10.1016\/S0140-6736(21)01169-7","article-title":"Spatial, temporal, and demographic patterns in prevalence of smoking tobacco use and attributable disease burden in 204 countries and territories, 1990\u20132019: a systematic analysis from the Global Burden of Disease Study 2019","volume":"397","author":"Reitsma","year":"2021","journal-title":"Lancet"},{"key":"2025021721441806400_ckae211-B4","author":"Healthy Belgium","year":"2023"},{"key":"2025021721441806400_ckae211-B5","author":"Sciensano","year":"."},{"key":"2025021721441806400_ckae211-B6","author":"Sciensano","year":"2019"},{"key":"2025021721441806400_ckae211-B7","doi-asserted-by":"crossref","first-page":"958","DOI":"10.1186\/s12889-017-4974-4","article-title":"The health-related social costs of alcohol in Belgium","volume":"17","author":"Verhaeghe","year":"2017","journal-title":"BMC Public Health"},{"key":"2025021721441806400_ckae211-B8","volume-title":"The Social Cost of Legal and Illegal Drugs in Belgium","author":"Lievens","year":"2016"},{"key":"2025021721441806400_ckae211-B9","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1016\/j.drugpo.2017.03.005","article-title":"Economic consequences of legal and illegal drugs: the case of social costs in Belgium","volume":"44","author":"Lievens","year":"2017","journal-title":"Int J Drug Policy"},{"key":"2025021721441806400_ckae211-B10","doi-asserted-by":"crossref","first-page":"cky213.830","DOI":"10.1093\/eurpub\/cky212.830","article-title":"Country report: the Belgian national burden of disease study 2020","volume":"28","author":"Devleesschauwer","year":"2018","journal-title":"Eur J Public Health"},{"key":"2025021721441806400_ckae211-B11","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/0778-7367-71-24","article-title":"Methodological basics and evolution of the Belgian health interview survey 1997\u20132008","volume":"71","author":"Demarest","year":"2013","journal-title":"Arch Public Health"},{"key":"2025021721441806400_ckae211-B12","author":"Intermutualistisch Agentschap","year":"."},{"key":"2025021721441806400_ckae211-B13","author":"RIZIV\u2014Rijksinstituut voor ziekte-en invaliditeitsverzekering","year":"."},{"key":"2025021721441806400_ckae211-B14","author":"Eurostat","year":"2024"},{"key":"2025021721441806400_ckae211-B15","doi-asserted-by":"crossref","first-page":"1693","DOI":"10.1186\/s12889-022-14105-9","article-title":"Health care costs and lost productivity costs related to excess weight in Belgium","volume":"22","author":"Gorasso","year":"2022","journal-title":"BMC Public Health"},{"key":"2025021721441806400_ckae211-B16","author":"Posit","year":"2023"},{"key":"2025021721441806400_ckae211-B17","author":"Sciensano","year":"."},{"key":"2025021721441806400_ckae211-B18","doi-asserted-by":"crossref","first-page":"62","DOI":"10.5539\/gjhs.v4n4p62","article-title":"Tobacco smoking: patterns, health consequences for adults, and the long-term health of the offspring","volume":"4","author":"Maritz","year":"2012","journal-title":"Glob J Health Sci"},{"key":"2025021721441806400_ckae211-B19","doi-asserted-by":"crossref","first-page":"490","DOI":"10.1097\/JOM.0000000000001302","article-title":"Smoking cessation is associated with lower indirect costs","volume":"60","author":"Baker","year":"2018","journal-title":"J Occup Environ Med"},{"key":"2025021721441806400_ckae211-B20","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1136\/tc.10.3.233","article-title":"Impact of smoking status on workplace absenteeism and productivity","volume":"10","author":"Halpern","year":"2001","journal-title":"Tob Control"},{"key":"2025021721441806400_ckae211-B21","doi-asserted-by":"crossref","first-page":"1","DOI":"10.2165\/00003495-200262002-00001","article-title":"The epidemiology of smoking: health consequences and benefits of cessation","volume":"62 Suppl 2","author":"Fagerstr\u00f6m","year":"2002","journal-title":"Drugs"},{"key":"2025021721441806400_ckae211-B22","author":"World Health Organization","year":"2019"},{"key":"2025021721441806400_ckae211-B23","doi-asserted-by":"crossref","first-page":"1202","DOI":"10.1093\/ntr\/ntz124","article-title":"Economic evaluation of five tobacco control policies across seven European countries","volume":"22","author":"Le\u00e3o","year":"2020","journal-title":"Nicotine Tob Res"},{"key":"2025021721441806400_ckae211-B24","doi-asserted-by":"crossref","first-page":"578","DOI":"10.1111\/dar.12504","article-title":"Social costs of illegal drugs, alcohol and tobacco in the European Union: a systematic review","volume":"36","author":"Barrio","year":"2017","journal-title":"Drug Alcohol Rev"},{"key":"2025021721441806400_ckae211-B25","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1186\/1471-2458-13-390","article-title":"An analysis of the economic impact of smoking cessation in Europe","volume":"13","author":"Cohen","year":"2013","journal-title":"BMC Public Health"},{"key":"2025021721441806400_ckae211-B26","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1016\/j.healthpol.2005.07.016","article-title":"Cost-of-illness analysis: what room in health economics?","volume":"77","author":"Tarricone","year":"2006","journal-title":"Health Policy"},{"key":"2025021721441806400_ckae211-B27","author":"World Health Organization","year":"."},{"key":"2025021721441806400_ckae211-B28","author":"World Health Organization","year":"."},{"key":"2025021721441806400_ckae211-B29","author":"World Health Organization"},{"key":"2025021721441806400_ckae211-B30","author":"VRGT","year":"2022"},{"key":"2025021721441806400_ckae211-B31","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1158\/1940-6207.CAPR-22-0172","article-title":"Urgent need for novel investigations of treatments to quit e-cigarettes: findings from a systematic review","volume":"15","author":"Palmer","year":"2022","journal-title":"Cancer Prev Res (Phila)"},{"key":"2025021721441806400_ckae211-B32","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1136\/tobaccocontrol-2021-056473","article-title":"Return on investment of Canadian tobacco control policies implemented between 2001 and 2016","volume":"32","author":"Tarride","year":"2023","journal-title":"Tob Control"},{"key":"2025021721441806400_ckae211-B33","author":"Vlaanderen\u2014Departement zorg","year":"2023"}],"container-title":["European Journal of Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/eurpub\/article-pdf\/35\/1\/108\/61577610\/ckae211.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/eurpub\/article-pdf\/35\/1\/108\/61577610\/ckae211.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,17]],"date-time":"2025-02-17T21:44:33Z","timestamp":1739828673000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/eurpub\/article\/35\/1\/108\/7974346"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,22]]},"references-count":33,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,1,22]]},"published-print":{"date-parts":[[2025,2,1]]}},"URL":"https:\/\/doi.org\/10.1093\/eurpub\/ckae211","relation":{},"ISSN":["1101-1262","1464-360X"],"issn-type":[{"value":"1101-1262","type":"print"},{"value":"1464-360X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,2]]},"published":{"date-parts":[[2025,1,22]]}}}