Background: Smoking plays a role in the development of chronic diseases and causes substantial negative economic consequences.
This study was carried out to estimate the annual cost of smoking-related cardio-cerebrovascular and pulmonary
diseases in the population by taking into account the direct costs associated with such co-morbid conditions in Indonesia.
Methods: Meta-analysis using the Mix-Programme Software of the data of patients from university medical centers who were
active smokers for more than a year and more than 20-pack years or passive smokers for more than a year and diagnosed with
Coronary Heart Disease, Myocardial Infarction, Stroke, COPD, Chronic bronchitis, or Lung Cancer had been conducted. Annual
direct cost was taken into account using the Decision Analysis Tree Age Pro (=DATA) software; cost data related to health care
expenditure were derived from secondary data sources in Jakarta. In addition, Population Attributable Risk (PAR) for each comorbid
conditions was calculated based on published epidemiological data from local and international journals.
Results: One-hundred and eighty-seven patients (96% male) satisfying the inclusion criteria, were analyzed, of whom confirmed
diagnosis of Stroke was amongst 29% of the patients, CHD 16%, Myocardial Infarction 16%, Lung Cancer 15%, COPD 17%, and
Chronic Bronchitis 7%. Mean direct annual cost was highest for Lung Cancer (Rp 51.6 million) followed by Myocardial infarction
(Rp 38.5 million) and CHD (Rp 37.8 million); PAR for various co-morbid conditions (based on variations in relative risk and
smoking prevalence estimates) were: Stroke ~16%-26%, CHD ~17%-27%, MCI ~ 22%-33%, Lung Cancer ~ 17%-26%, COPD ~
13%-21%, Chronic Bronchitis ~ 42%-59%.
Conclusions: Annual cost of smoking-related diseases in Indonesia has been estimated. The highest cost is for Lung Cancer. The
highest PAR is for Chronic Bronchitis
