{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T23:40:48Z","timestamp":1792798848055,"version":"4.5.0"},"reference-count":20,"publisher":"BMJ","issue":"2","funder":[{"name":"Department of Health, Government of the Hong Kong SAR","award":["NOT APPLICABLE"],"award-info":[{"award-number":["NOT APPLICABLE"]}],"id":[{"id":"https:\/\/ror.org\/030jqbn26","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Tob Control"],"accepted":{"date-parts":[[2024,11,5]]},"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Hong Kong has one of the lowest smoking prevalence both within China and among high-income economies. As tobacco use consistently declined over the past decades, we examine whether there are corresponding cost reductions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data were sourced from diverse population-wide datasets including government reports and public hospital records. Costs were calculated using Global Burden of Disease (GBD) 2019 risk estimates for active smoking. Direct costs encompassed public and private healthcare expenses, while indirect costs included the value of years of productive life lost, days off work due to active smoking or secondhand smoke exposure, and long-term care costs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>Active smoking accounted for 26.3% of deaths in people aged 35 or over. Healthcare costs amounted to US$342\u2009million and US$45\u2009million for active and secondhand smoking. Annual tobacco-related diseases reached US$1.27\u2009billion (0.3% of 2021 Hong Kong GDP). Compared with previous methods, the analysis using GBD 2019 risk estimates showed a twofold increase in lives lost due to active smoking but a 31.0% decrease for secondhand smoking.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interpretation<\/jats:title>\n                    <jats:p>Past studies greatly underestimate the health burden of tobacco compared with more recent data on the wider risks. Despite a decline in smoking prevalence, the total costs associated with smoking have risen as utilisation shifts from primary care towards more expensive specialist care. The long-term health and economic impacts of tobacco use remain substantial even in regions of China that have now achieved low smoking prevalence.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/tc-2024-058817","type":"journal-article","created":{"date-parts":[[2024,11,29]],"date-time":"2024-11-29T01:25:25Z","timestamp":1732843525000},"page":"179-186","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Economic costs of tobacco-related diseases in Hong Kong in 2021"],"prefix":"10.1136","volume":"35","author":[{"given":"Carmen S","family":"Ng","sequence":"first","affiliation":[{"name":"School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Coco Wing Sze","family":"Yu","sequence":"additional","affiliation":[{"name":"School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lancelot","family":"Leung","sequence":"additional","affiliation":[{"name":"School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eponine Kate","family":"Wong","sequence":"additional","affiliation":[{"name":"School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9485-0273","authenticated-orcid":false,"given":"Sai Yin","family":"Ho","sequence":"additional","affiliation":[{"name":"School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dennis K M","family":"Ip","sequence":"additional","affiliation":[{"name":"School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yongda","family":"Wu","sequence":"additional","affiliation":[{"name":"School of Nursing, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong"},{"name":"CHEO Research Institute, Ottawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4000-2388","authenticated-orcid":false,"given":"Man Ping","family":"Wang","sequence":"additional","affiliation":[{"name":"School of Nursing, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8386-8512","authenticated-orcid":false,"given":"Jianchao","family":"Quan","sequence":"additional","affiliation":[{"name":"School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong"},{"name":"HKU Business School, The University of Hong Kong, Hong Kong, Hong Kong SAR, Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,11,28]]},"reference":[{"key":"2026102203551406000_35.2.179.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)30819-X"},{"key":"2026102203551406000_35.2.179.2","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(20)30925-9"},{"key":"2026102203551406000_35.2.179.3","doi-asserted-by":"crossref","DOI":"10.18332\/tid\/120102","article-title":"Economic burden of smoking-attributable diseases in China: A systematic review","volume":"18","author":"Shi","year":"2020","journal-title":"Tob Induc Dis"},{"key":"2026102203551406000_35.2.179.4","doi-asserted-by":"crossref","DOI":"10.1186\/s12913-021-06199-5","article-title":"The impact of smoking on annual healthcare cost: an econometric model analysis in China, 2015","volume":"21","author":"Huang","year":"2021","journal-title":"BMC Health Serv Res"},{"key":"2026102203551406000_35.2.179.5","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2019.00291"},{"key":"2026102203551406000_35.2.179.6","doi-asserted-by":"publisher","DOI":"10.1136\/tc.2010.042028"},{"key":"2026102203551406000_35.2.179.7","unstructured":"World Bank . DataBank - world development indicators. 2023. Available: https:\/\/databank.worldbank.org\/reports.aspx?source=world-development-indicators [Accessed 20 Dec 2023]."},{"key":"2026102203551406000_35.2.179.8","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2018.0158"},{"key":"2026102203551406000_35.2.179.9","unstructured":"Cigarette smoking \u2014 a persistent burden on the US economy. Available: https:\/\/www.thelancet.com\/infographics-do\/cigarette-smoking-persistent-burden-us-economy [Accessed 30 Jan 2024]."},{"key":"2026102203551406000_35.2.179.10","unstructured":"Tobacco and Alcohol Control Office, Department of Health . Info-station - statistics - pattern of smoking in Hong Kong. 2023. Available: https:\/\/www.taco.gov.hk\/t\/english\/infostation\/infostation_sta_01.html [Accessed 28 Mar 2023]."},{"key":"2026102203551406000_35.2.179.11","unstructured":"Health Bureau, Hong Kong SAR . Vibrant, healthy and tobacco-free Hong Kong consultation document on tobacco control strategies."},{"key":"2026102203551406000_35.2.179.12","doi-asserted-by":"publisher","DOI":"10.1136\/tc.2005.013292"},{"key":"2026102203551406000_35.2.179.13","doi-asserted-by":"publisher","DOI":"10.1093\/ntr\/ntx254"},{"key":"2026102203551406000_35.2.179.14","unstructured":"Hong Kong Council on Smoking and Health, Hong Kong SAR . Tobacco control policy-related survey 2020 COSH report no.29."},{"key":"2026102203551406000_35.2.179.15","unstructured":"Global Burden of Disease Collaborative Network . Global burden of disease study 2019 (GBD 2019) smoking tobacco use prevalence 1990-2019. 2021."},{"key":"2026102203551406000_35.2.179.16","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-023-02743-4"},{"key":"2026102203551406000_35.2.179.17","unstructured":"United States Surgeon General . The health consequences of smoking -- 50 years of progress: a report of the surgeon general: (510072014-001). 2014."},{"key":"2026102203551406000_35.2.179.18","doi-asserted-by":"publisher","DOI":"10.1136\/oem.59.12.842"},{"key":"2026102203551406000_35.2.179.19","doi-asserted-by":"crossref","first-page":"e1006","DOI":"10.1016\/S2468-2667(23)00242-6","article-title":"Tobacco control in China","volume":"8","author":"Chan","year":"2023","journal-title":"Lancet Public Health"},{"key":"2026102203551406000_35.2.179.20","doi-asserted-by":"publisher","DOI":"10.1136\/tobaccocontrol-2021-056890"}],"container-title":["Tobacco Control"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/tc-2024-058817","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T18:41:55Z","timestamp":1792694515000},"score":1,"resource":{"primary":{"URL":"https:\/\/tobaccocontrol.bmj.com\/lookup\/doi\/10.1136\/tc-2024-058817"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,28]]},"references-count":20,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,4,13]]},"published-print":{"date-parts":[[2026,3]]}},"alternative-id":["10.1136\/tc-2024-058817"],"URL":"https:\/\/doi.org\/10.1136\/tc-2024-058817","relation":{},"ISSN":["0964-4563","1468-3318"],"issn-type":[{"value":"0964-4563","type":"print"},{"value":"1468-3318","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,11,28]]}}}