12:38am Tuesday 26 September 2017

Health care costs resulting from cigarette smoking are considerably higher than previously assumed

The results of the study have now been published in the specialist journal BMC Health Services Research.

Health care costs resulting from cigarette smoking are considerably higher than previously assumed

Previous analyses of the effects of cigarette smoking have been based on aggregate calculation models which were unable to take all health-related consequences into account. The first detailed approach in Germany, the costs of medical care and work absenteeism incurred by smokers and non-smokers were analyzed now using individual data from the population-based cross-sectional KORA study. For more than 20 years, the KORA studies have been examining the health of thousands of individuals as well as the effects of environmental factors, lifestyle and genes.

Prof. Reiner Leidl (left), Margarethe Wacker, Institute of Health Economics and Health Care Management. Photo: Helmholtz Zentrum München

The data analyses showed that the costs of medical care and work absenteeism incurred by smokers were 24 per cent higher than for non-smokers; those incurred by former smokers, including those who stopped smoking for health reasons, were 35 per cent higher. For the year 2008, the additional costs attributed to smokers were calculated at more than 700 euros, while the extra costs per former smoker were estimated at 1,100 euros. Thanks to more accurate calculation methods, the study revealed that health care costs for smokers were twice as high as previously estimated.

“Smoking is one of the greatest, avoidable health risks,” says Prof. Reiner Leidl, who heads the Institute for Health Economics and Health Care Management at the Helmholtz Zentrum München. “An accurate estimate of health care costs is needed to efficiently implement prevention.” Despite widespread awareness of the related health risks, about 30 per cent of adult Germans still smoke. Successful prevention can avoid placing a greater burden on health care services, and resulting benefits to individual health, as well as to society are therefore greater than was previously assumed.

Further information

Original publication:
The association of smoking status with healthcare utilisation, productivity loss and resulting costs: results from the population-based KORA F4 study.
Margarethe Wacker, Rolf Holle, Joachim Heinrich, Karl-Heinz Ladwig, Annette Peters, Reiner Leidl, Petra Menn   
BMC Health Services Research 2013, 13:278

Link to specialist publication 

Helmholtz Zentrum München, the German Research Center for Environmental Health, pursues the goal of developing personalized medical approaches to the prevention and therapy of major common diseases such as diabetes and lung diseases. To achieve this, it investigates the interaction between genetics, environmental factors and lifestyle. The Helmholtz Zentrum München has about 2,100 staff members and is headquartered in Neuherberg in the north of Munich. It is a member of the Helmholtz Association, a community of 18 scientific-technical and medical-biological research centers with a total of about 34,000 staff members.

The Institute of Health Economics and Health Care Management (IGM) examines approaches to improving the effectiveness and efficiency of health care. The health care system faces the challenge of delivering high-quality, economically viable medical services to meet the needs of the population. Rapid advances in medical technology and fast-changing demographics further aggravate this problem. A firmly based evaluation of the effectiveness and efficiency of health care structures and processes is therefore an essential prerequisite for a rational health care policy.

For more than 20 years,KORA (Cooperative Health Research in the Augsburg Region) has been investigating the health of thousands of individuals living in and around the city of Augsburg in Germany. The aim is to understand the impact of environmental factors, behavior and genes. The KORA studies focus on the etiology and development of chronic diseases, in particular myocardial infarction and diabetes mellitus. For this purpose, lifestyle risk factors (e.g. smoking, nutrition, exercise), environmental factors (e.g. air pollution, noise) and genetics are studied. Health care research therefore examines questions relating to the utilization and cost of health care services.www.helmholtz-muenchen.de/kora

Specialist contact

Margarethe Wacker, Helmholtz Zentrum München – German Research Center for Environmental Health (GmbH), Institute of Health Economics and Health Care Management (IGM), Ingolstädter Landstrasse 1, 85764 Neuherberg – Tel.: +49 89-3187-4166 E-mail


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