The costs of smoking in Vietnam: the case of inpatient care.

OBJECTIVE: To estimate the social costs of smoking related to inpatient care in Vietnam using 2005 data. DESIGN: The cost of illness as a result of hospitalisation for three major smoking-related diseases combined with the prevalence-based approach to obtain the costs of smoking in Vietnam for inpatient care. MAIN OUTCOME MEASURE: Smoking-attributable costs of inpatient care for lung cancer, chronic obstructive pulmonary disease (COPD), and ischaemic heart disease. RESULTS: The total cost of inpatient health care caused by smoking in Vietnam reached at least 1 161 829 million Vietnamese dollars ($VN) (or $US 77.5 million) in 2005. This represents about 0.22% of Vietnam gross domestic product (GDP) and 4.3% of total healthcare expenditure. The majority of these expenses are related to COPD treatment ($VN 1,033541 million or $US 68.9 million per year) followed by lung cancer ($VN 78,143 million, or $US 5.2 million per year) and ischaemic disease ($VN 50,145 million, or $US 3.3 million per year). The government directly finances about 51% of these costs. The rest is financed either by households (34%) or by the insurance sector (15%). CONCLUSIONS: The social costs of smoking in Vietnam as the percentage of GDP is lower compared to estimates from high-income countries. The true costs would be substantially higher if all smoking-related diseases, outpatient care and mortality-related costs are included. More research is needed to augment the estimates presented in this paper.