Pubdate: Sat, 01 Feb 2003
Source: British Medical Journal, The (UK)
Issue: BMJ 2003;326:242 ( 1 February )
Copyright: 2003 The BMJ
Contact:  http://www.bmj.com/
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Author: Christopher Zinn

SOCIAL COSTS OF SMOKING ARE TRIPLE THOSE OF ILLICIT DRUGS

The financial impact of tobacco and alcohol far outweigh the impact of 
illicit drugs, with smoking costing the community almost three times as 
much as any other category of drug, according to a study on the social 
costs of drug use in Australia.

The report, produced for the federal government's national drug strategy, 
estimates that tobacco accounted for 61.2% of the costs to society of 
drugs, or $A21bn (£7.6bn; $12.4bn; ¬11.5bn). For the first time the cost 
calculations included an estimate of the impact of passive smoking and 
newly available data to assess the effect on the Australian population of 
absenteeism, drugs, ambulances, fires, crime, and even litter.

Alcohol accounted for 22% of total costs ($A7.5bn) and illegal drugs for 
17% ($A6.0bn). The calculations for the survey period, 1998-9, included 
both tangible and intangible costs to individuals, companies, and 
governments. Tangible costs included hospital care, road crashes, loss of 
productivity and tax revenue, and increased crime and policing. The 
intangible costs included pain and suffering.

The methods used in this report, the third of its kind, differed so much 
from the previous reports as to preclude comparisons. Long lists of 
conditions associated with different types of drug use - such as 
hypertension (associated with alcohol), ischaemic heart disease (smoking), 
and low birth weight (cocaine) - were compiled. The authors found it 
impossible to estimate the costs of the misuse of prescribed pharmaceuticals.

One of the authors, David Collins, a professor in economics at Sydney's 
Macquarie University, said the report had, for the first time, measured the 
cost of passive smoking, assessing it at A$47m. Fires resulting from 
cigarettes were estimated to cost A$81m.

"A lot of the impact of . . . involuntary smoking is on the unborn child 
and on children under 14 years. It hits the young very hard because they 
have no control over their lives," he told the Sydney Morning Herald (21 
Jan). "Tobacco is still the greatest killer by far and imposes the greatest 
costs."

The report said the costs were all net costs and, consistent with previous 
studies, were estimated conservatively. Lower cost alternatives were 
selected when there was a choice.

Cannabis, opiates, stimulants, hallucinogens, and anabolic steroids were 
listed as illicit drugs.

Alcohol was found to have prevented more deaths than it caused because of 
the beneficial effects of moderate consumption. In the survey period 4286 
people reportedly died because of alcohol but 7029 deaths were avoided.

Drug agencies said that they had been aware that tobacco and alcohol were 
responsible for more problems than were illicit drugs, but they added that 
the report would show the general public how legal drugs had much more impact.

Professor Collins said the report showed that the costs of drug use are so 
high that the benefits from even a small reduction in consumption could be 
large.

"Antitobacco programmes yield very high rates of return, and the same is 
true for illicit drugs," he said.

Counting the Cost is at 
www.nationaldrugstrategy.gov.au/new/ 
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MAP posted-by: Beth