Objective: To estimate the short-term benefits of a reduction in smoking on acute myocardial infarction (AMI) and stroke hospitalisations and costs.
Design and setting: Epidemiological study which applied functions describing reductions over time in risk of AMI and stroke in people quitting smoking to hospitalisation rates and costs for Australia.
Main outcome measures: The numbers of AMI and stroke hospitalisations in 35–64-year-olds and the associated costs that could have been avoided over a 7-year period from 2001–02 if smoking prevalence had decreased by 1% in the first year (Scenario 1) or by 1% per annum for 5 consecutive years (Scenario 2).
Results: Under Scenario 1, almost 1000 hospitalisations for AMI and about 350 hospitalisations for stroke would have been avoided over 7 years, saving about $20.4 million in health care costs. Under Scenario 2, over 3000 AMI hospitalisations and over 1000 stroke hospitalisations would be avoided, and health care costs could be reduced by $61.6 million (2.75% of costs for AMI and stroke over the period).
Conclusions: This study provides further support for the proposition that modest and achievable reductions in smoking rates can substantially improve health outcomes and reduce health care costs, even in the short term.
- 1. White V, Hill D, Siahpush M, Bobevski I. How has the prevalence of cigarette smoking changed among Australian adults? Trends in smoking prevalence between 1980 and 2001. Tobacco Control 2003; 12 Suppl II: ii67-ii74.
- 2. Mathers CD, Vos ET, Stevenson CE, Begg SJ. The Australian Burden of Disease Study: measuring the loss of health from diseases, injuries and risk factors. Med J Aust 2000; 172: 592-596. <MJA full text>
- 3. State-specific prevalence of current cigarette smoking among adults - United States, 2002. MMWR Morb Mortal Wkly Rep 2004; 52: 1277-1280.
- 4. VicHealth Centre for Tobacco Control. Tobacco control: a blue chip investment in public health. Melbourne: The Cancer Council, Victoria, 2003.
- 5. Ridolfo B, Stevenson C. Quantification of drug-caused mortality and morbidity in Australia, 1998. Drug statistics series, no. 7. Canberra: Australian Institute of Health and Welfare, 2001. (AIHW Cat. No. PHE-29 ed.)
- 6. Lightwood JM, Glantz SA. Short-term economic and health benefits of smoking cessation. Circulation 1997; 96: 1089-1096.
- 7. Naidoo B, Stevens W, McPherson K. Modelling the short term consequences of smoking cessation in England on the hospitalisation rates for acute myocardial infarction and stroke. Tob Control 2004; 9: 397-400.
- 8. Rosenberg L, Kaufman DW, Helmrich SP, Shapiro S. The risk of myocardial infarction after quitting smoking in men under 55 years of age. N Engl J Med 1985; 313: 1511-1514.
- 9. Rosenberg L, Palmer JR, Shapiro S. Decline in the risk of myocardial infarction among women who stop smoking. N Engl J Med 1990; 322: 213-217.
- 10. Kawachi I, Colditz G, Stampfer MJ, et al. Smoking cessation and time course of decreased risks of coronary heart disease in middle-aged women. Arch Int Med 1994; 154: 169-175.
- 11. Willett WC, Hennekens CH, Bain C, et al. Cigarette smoking and non-fatal myocardial infarction in women. Am J Epidemiol 1981; 113: 575-582.
- 12. Dobson AJ, Alexander HM, Heller RF, Lloyd DM. How soon after quitting smoking does risk of heart attack decline? J Clin Epidemiol 1991; 44: 1247-1253.
- 13. Kawachi I, Colditz G, Stampfer MJ, et al. Smoking cessation and decreased risk of stroke in women. JAMA 1993; 269: 232-236.
- 14. Wannamethee SG, Shaper G, Whincup PH, Walker M. Smoking cessation and the risk of stroke in middle-aged men. JAMA 1995; 274: 155-160.
- 15. McElduff P, Dobson A, Beaglehole R, Jackson R. Rapid reduction in coronary risk for those who quit cigarette smoking. Aust N Z J Public Health 1998; 22: 787-791.
- 16. Hardie K, Hankey GJ, Jamrozik K, et al. Ten-year survival after first-ever stroke in the Perth community stroke study. Stroke 2003; 34: 1842-1846.
- 17. Mathur S. Epidemic of coronary heart disease and its treatment in Australia. Cardiovascular disease series, number 20. Canberra: Australian Institute of Health and Welfare, 2002.
- 18. Dewey H, Thrift AG, Mihalopoulos C, et al. Lifetime cost of stroke subtypes in Australia. Findings from the North East Melbourne Stroke Incidence Study (NEMESIS). Stroke 2003; 34: 2502-2507.
- 19. Hurley SF, Scollo MM, Younie SJ, et al. The potential for tobacco control to reduce PBS costs for smoking-related cardiovascular disease. Med J Aust 2004; 181: 252-255. <MJA full text>
- 20. Sargent RP, Shepard RM, Glantz SA. Reduced incidence of admissions for myocardial infarction associated with public smoking ban: before and after study. BMJ 2004; 328: 977-983.
- 21. Whincup PH, Gilg JA, Emberson JR, et al. Passive smoking and risk of coronary heart disease and stroke: prospective study with cotinine measurement. BMJ 2004; 329: 200-205.
Publication of your online response is subject to the Medical Journal of Australia's editorial discretion. You will be notified by email within five working days should your response be accepted.