Potential cost saving associated with smoking prevention and cessation: an incidence-based cost-of-illness analysis in Thailand

Background While assessing the lifetime cost of smoking is critical for evaluating tobacco control policies, the available evidence remains limited. This study aimed to estimate the lifetime costs of smoking and the economic benefits of smoking prevention and cessation at varying ages. Methods An incidence-based cost-of-illness analysis was performed using a hybrid decision tree-Markov modelling approach. Four major smoking-attributable diseases were included: chronic obstructive pulmonary disease, lung cancer, ischaemic heart disease and stroke. The analysis was conducted from a societal perspective, accounting for direct healthcare costs and indirect costs. All costs were presented in 2024 Thai Baht (THB: US$1=THB 35.29). Results The excess costs for an individual who smokes throughout their lifetime were estimated at THB 0.93 million for males and THB 0.96 million for females. Compared with an individual who has never smoked, smoking reduced life expectancy by 9.54 years for males and 8.18 years for females. Smoking cessation generated substantial savings; for males, these ranged from THB 0.04 million (quitting at age 65 years) to THB 0.58 million (quitting at age 25 years). Among females, individuals who quit smoking at the same ages could save THB 0.19 million and THB 0.67 million, respectively. On average, the excess cost per Thai individual who smokes was estimated at THB 0.67 million. Conclusion These findings demonstrate the substantial economic burden of smoking and underscore the need for targeted public health initiatives. Emphasis on prevention and early cessation is essential to optimise health outcomes while generating greater cost savings.