Smoking costing the health service ¤172m each year

Males are worst affected by habit-related illnesses

SMOKING costs €172million a year to the health service, a new HSE study is warning.

In Ireland, 20% of adults continue to smoke. Many current and ex-smokers live with ill health and disability as a result of smoking, and the study aimed to quantify the extent of smoking-related hospitalisations in Irish publicly funded hospitals.

The study, Counting the Toll of Smoking-Attributable Hospitalisations, on behalf of the HSE Tobacco Free Ireland Programme, found that in 2016, there were

5,950 smokers died in 2016

21,486 day case admissions, 33,615 inpatient hospital admissions consuming 309,117 bed days.

All were attributable to smoking and exposure to second-hand smoke, with an estimated cost of €172million in publicly funded hospitals.

This represents 2% of day case admissions, 5% of inpatient admissions, and 8% of inpatient bed days for that year.

The study, published in this month’s Irish Medical Journal, found that Irish men smoke more than Irish women, 22% versus 17%. That was based on 2018 figures which showed that 20% of irish adults aged 15 and above smoked.

In Ireland, in 2016, it is estimated that almost 5,950 people died as a direct result of smoking with an additional 100 deaths estimated to be as a result of exposure to second-hand smoke.

While there has been a reduction in smoking prevalence in recent years, the study found that continued progress is required since Tobacco-Free Ireland, government policy on tobacco control, sets an ambitious target for Ireland to be tobacco-free.

However, quitting intentionality, and the proportion of quit attempts among men and women is similar.

Successfully quitting smoking is difficult, and the majority of smokers attempting to quit while using no supports is 42%, while 41% use e-cigarettes.

Findings show that chronic obstructive pulmonary disease (COPD) was the condition which most affected men and women. Up to 90% of men who smoked and 84.3% of women were affected.

Some 80% of men suffered with lung cancer, trachea and bronchus and 83.5% with cancer of the larynx. Other conditions affecting high levels of both men and women are coronary heart disease, pneumonia, influenza and pancreatic cancer.

Almost 60% of both inpatient admissions at 19,688 and day case admissions (12,633) were by men. Overall, the burden of smoking and second-hand smoke-related hospitalisation is greater for men than women, with 7% of all hospitalisations among males estimated to be smoking or secondhand smoke related, compared to 4% amongst women.

Author of the report, Aishling Sheridan, from the HSE Tobacco Free Ireland Programme said: ‘In 2018, 20% of Irish adults smoke, with high smoking rates among young people; this compares favourably to a smoking prevalence of 29% in 2007.

‘And, while smoking prevalence is falling and will continue to, in the attempt to achieve a smokefree Ireland by 2025, many people will continue to live with the health effects of their smoking into the future.

‘A recent Irish study detailed the impact of smoking on the health of older Irish adults: those who smoked self-reported poorer physical and mental health, and considered their own health to be worse than their peers; in addition, the prevalence of selfreported smoking-related chronic diseases was highest among ex-smokers, and the extent of this ill health was related to the amount smoked.

‘Quitting smoking results in many physical and mental health gains; specifically, reduced risk of death from cardiovascular disease and COPD, and stopping smoking before age 40 reverts life expectancy close to that of non-smokers. So, in order to maximise the benefits of quitting smoking, smokers must quit at a younger age,’ said Ms Sheridan.

She added that an interesting finding of the study is the greater burden of smoking-related disease for men.

‘This analysis highlights the impact of tobacco on Irish adults, especially males. For the health services, this analysis highlights the potential savings if Ireland was tobacco-free,’ she said.

Poorer physical and mental health