For the first time in Argentina, a study conducted by the Institute for Clinical and Health Effectiveness (IECS), with funding from the Institute of Cancer Research (ICRC), estimated the health and economic burden of smoking by socioeconomic level. The results indicated that people with lower incomes not only smoke more, but also get sick and die more from tobacco-related causes, and spend a much larger proportion of their income on dealing with its consequences. At the same time, the control policies recommended by the World Health Organization (WHO) could significantly reduce these inequalities.
Presented in the framework of World No Tobacco Day, the study analyzes this issue for the first time in the country by income quintile, highlighting how smoking exacerbates health and economic inequality.
"Smoking is bad for everyone, but not in the same way or at the same cost. This study clearly demonstrates that smoking hits those with less income hardest."," explained Natalia Espínola, Master's in Economics, principal investigator of the study and coordinator of Health Economics at the IECS.
According to the analysis, 26% of low-income people smoke, compared to 21% in higher-income households. This translates into more deaths (11.855 vs. 11.085) and more illnesses (109.838 vs. 95.405) among the lowest quintiles. Although annual health expenditure associated with smoking is similar between both groups ($370.906 vs. $394.112), its economic impact is very different: it represents 26,3% of income in the lowest-income households, compared to 3,5% in the richest. When indirect costs such as lost productivity and informal care time are added, the total burden rises to 68% of income in lower-income households.
"Tobacco not only makes people sick and kills, it also impoverishes them. People with lower incomes face more barriers to accessing health care and a greater risk of falling into poverty due to the costs of the disease."added Federico Augustovski, co-author of the study and director of the Department of Health Technology Assessment and Health Economics at IECS.
The study also assessed the impact of fully implementing WHO-recommended tobacco control policies—such as tax increases, plain packaging, advertising bans, and smoke-free environments—and concluded that while they would benefit the entire population, their impact would be especially significant for the most vulnerable.
For example, increasing the price of cigarettes by 50% and adopting plain packaging would prevent twice as many deaths in the lowest income quintiles and generate 14 times greater savings in out-of-pocket costs compared to the wealthiest. These measures would also prevent thousands of cases of catastrophic health expenditure and prevent many families from falling into poverty as a result of smoking.
This new approach, based on evidence and developed with methodological rigor, positions smoking not only as a health problem, but as a concrete cause of inequity that can be addressed with effective public policy tools.
Further information:
See press release issued in the framework of World No Tobacco Day here
Access the infographic from here