{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T16:37:33Z","timestamp":1781800653889,"version":"3.54.5"},"reference-count":24,"publisher":"BMJ","issue":"Suppl 2","license":[{"start":{"date-parts":[[2022,12,15]],"date-time":"2022-12-15T00:00:00Z","timestamp":1671062400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"University of Illinois at Chicago's Institute for Health Research and Policy","award":["16872"],"award-info":[{"award-number":["16872"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Tob Control"],"accepted":{"date-parts":[[2022,12,2]]},"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The lack of reliable tobacco healthcare and economic cost estimates leaves the tobacco industry undertaxed and thriving in Pakistan and makes the country as one of the top tobacco-consuming nations. To facilitate effective tobacco tax policymaking, this study estimates the economic cost of smoking-attributable diseases and deaths in Pakistan.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A nationally representative sample survey of 13\u2009000 households was administered to gather the data required to estimate different cost components of smoking-attributable diseases through the prevalence-based approach.<\/jats:p><\/jats:sec><jats:sec><jats:title>Findings<\/jats:title><jats:p>The total smoking-attributable economic cost of all diseases and deaths in Pakistan in the year 2018\u20132019 for persons aged 35 years or older is 615.07 billion ($3.85 billion). Similarly, three major diseases, namely cancer, cardiovascular disease and respiratory disease, along with associated deaths, cost the nation PKR437.8 billion ($2.7 billion) of which 77% is the indirect cost. The three major diseases make 71% of the total estimated cost, nearly two-thirds of which is borne by rural residents, nine-tenth by males and more than four-fifths by the citizens in the 35\u201364 years age group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The total annual economic costs of all smoking-attributable diseases and deaths and those of the three major diseases equal 1.6% and 1.15% of Pakistan\u2019s gross domestic product, respectively. The tax contribution of tobacco sector is merely 20% of the total estimated cost. The finding of huge economic and health costs of smoking makes a convincing case for policymakers to realise the true value of the industry\u2019s contribution and raise tobacco taxes to the level of full cost recovery.<\/jats:p><\/jats:sec>","DOI":"10.1136\/tc-2022-057726","type":"journal-article","created":{"date-parts":[[2022,12,15]],"date-time":"2022-12-15T18:22:49Z","timestamp":1671128569000},"page":"101-107","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":9,"title":["Economic burden of tobacco use in Pakistan"],"prefix":"10.1136","volume":"33","author":[{"given":"Junaid Alam","family":"Memon","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4875-6021","authenticated-orcid":false,"given":"Muhammad","family":"Nasir","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Durre","family":"Nayab","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omer","family":"Siddique","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shabana","family":"Kishwar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2022,12,15]]},"reference":[{"key":"2024070202402320000_33.Suppl_2.101.1","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1055\/s-0031-1278254","article-title":"Cigarette smoke and adverse health effects: an overview of research trends and future needs","volume":"16","author":"Saha","year":"2007","journal-title":"Int J Angiol"},{"key":"2024070202402320000_33.Suppl_2.101.2","doi-asserted-by":"crossref","first-page":"294","DOI":"10.1093\/ntr\/ntaa154","article-title":"Economic costs of diseases and deaths attributable to tobacco use in India, 2017-2018","volume":"23","author":"John","year":"2021","journal-title":"Nicotine Tob Res"},{"key":"2024070202402320000_33.Suppl_2.101.3","first-page":"567","article-title":"Prevalence of tobacco product consumption and exposure among healthcare students in King Saud university in Riyadh, Saudi Arabia","volume":"7","author":"Amin","year":"2017","journal-title":"Community Med Health Educ"},{"key":"2024070202402320000_33.Suppl_2.101.4","doi-asserted-by":"crossref","first-page":"i5","DOI":"10.1136\/tc.2005.015412","article-title":"Economic burden of smoking in China, 2000","volume":"15 Suppl 1","author":"Sung","year":"2006","journal-title":"Tob Control"},{"key":"2024070202402320000_33.Suppl_2.101.5","unstructured":"GATS . Global adult tobacco survey (report, 2014."},{"key":"2024070202402320000_33.Suppl_2.101.6","unstructured":"WHO . Economics of tobacco toolkit: assessment of the economic costs of smoking, 2011."},{"key":"2024070202402320000_33.Suppl_2.101.7","doi-asserted-by":"publisher","DOI":"10.1136\/tc.8.3.290"},{"key":"2024070202402320000_33.Suppl_2.101.8","doi-asserted-by":"publisher","DOI":"10.1093\/eurpub\/10.1.31"},{"key":"2024070202402320000_33.Suppl_2.101.9","doi-asserted-by":"publisher","DOI":"10.1136\/tc.2008.027466"},{"key":"2024070202402320000_33.Suppl_2.101.10","doi-asserted-by":"publisher","DOI":"10.1136\/tobaccocontrol-2018-054493"},{"key":"2024070202402320000_33.Suppl_2.101.11","doi-asserted-by":"publisher","DOI":"10.1136\/tc.2010.042028"},{"key":"2024070202402320000_33.Suppl_2.101.12","doi-asserted-by":"publisher","DOI":"10.1136\/tc.2007.020396"},{"key":"2024070202402320000_33.Suppl_2.101.13","doi-asserted-by":"publisher","DOI":"10.1136\/tobaccocontrol-2017-053791"},{"key":"2024070202402320000_33.Suppl_2.101.14","doi-asserted-by":"publisher","DOI":"10.1093\/ntr\/ntx179"},{"key":"2024070202402320000_33.Suppl_2.101.15","doi-asserted-by":"publisher","DOI":"10.1136\/tobaccocontrol-2019-055232"},{"key":"2024070202402320000_33.Suppl_2.101.16","unstructured":"GoP . 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