Economic costs of tobacco use: Kerala surpasses neighbours

Kerala has emerged as a leader of sorts in South India with the huge economic burden it shoulders on account of tobacco use. God’s Own Country has left behind its tobacco cultivating neighbours – Karnataka and Tamil Nadu, reveals the findings of a major recent national study conducted to estimate the economic dimensions of tobacco use.

The study supported by the Union Ministry of Health & Family Welfare and the World Health Organisation brings out that the economic resources lost in treating and managing four major tobacco-induced diseases is nearly 75 per cent more than Karnataka. While Kerala burns out Rs 545.4 crores, it is Rs 314.7 crores in Karnataka.

Monetary resources lost due to tobacco use in Tamil Nadu is nearly 17 per cent lesser than Kerala, at Rs 467 crores.

The report following the study called ‘Economic Burden of Tobacco Related Diseases in India’ developed by the Public Health Foundation of India has estimated the economic costs on persons aged 35 – 69 in the year 2011. It has estimated both direct medical costs and indirect morbidity costs in two categories – all tobacco-induced diseases, and four specific diseases – cardiovascular diseases (CVDs); cancer, tuberculosis and respiratory disease.

Direct medical costs include direct healthcare expenditure for inpatient hospitalisation or outpatient visits such as medicines, diagnostic tests, bed charges and surgeon’s fees. Indirect costs accrue from expenses incurred on transportation and lodging charges for caregivers, loss of household income due to inpatient hospitalisation, besides costs from premature death. 

A similar pattern prevails with regard to economic burden of tobacco use from all diseases, with Kerala facing a greater pinch than Karnataka and Tamil Nadu. The economic cost in Kerala on all diseases is Rs 1513.7 crores, as against Rs 983.1 crores in Karnataka and Rs 1171.3 crores in Tamil Nadu.

In line with consumption patterns, tobacco-induced costs are higher among Kerala males as compared to females. Among males, higher costs – both direct and indirect – accrue from smoking tobacco products as against smokeless tobacco products.

On four diseases specifically, tobacco use among Kerala males causes a loss of Rs 518.9 crores, which is nearly 90 per cent more than in Karnataka and 40 per cent more than in Tamil Nadu. Tobacco induced economic costs among Kerala females is Rs 26.4 crores.

Kerala’s saving grace is Andhra Pradesh, a major tobacco producing state in India, which leads with the highest economic burden due to tobacco use among southern states.

The study, among others, recommends prioritisation of tobacco control measures such as strengthening implementation of Indian tobacco control law, COTPA, 2003; uniform taxes on all tobacco products such as cigarettes and bidis; prohibition on sale and manufacture of all forms of smokeless tobacco products/chewing tobacco and high visibility public awareness campaigns to consistently reach different target audiences.

The Value Added Tax on cigarettes in Kerala is 22 per cent and bidis are not taxed at all.