Abstract

Globally, tobacco consumption continues to cause a considerable burden of preventable diseases. Although the smoking prevalence in Nigeria may be declining over the last years, the absolute number of active smokers remains one of the highest in Africa. Little is known about the disease burden and economic costs of cigarette smoking in Nigeria. Consequently, there is an evidence gap to inform the design and implementation of an effective policy for tobacco control. We applied a microsimulation model to estimate the burden attributable to smoking in terms of morbidity, mortality, disability-adjusted life-years (DALYs), and direct medical costs and indirect costs (e.g., productivity loss costs, informal caregivers' costs). We also modeled the health and economic impact of different scenarios of tobacco price increases through taxes. We estimated that smoking is responsible for approximately 29,000 annual deaths in Nigeria. This burden corresponds to 816,230 DALYs per year. In 2019, the total economic burden attributable to tobacco was estimated at ₦ 634 billion annually (approximately U$D 2.07 billion). If tobacco cigarettes' prices were to be raised by 50% through taxes, more than 30,000 deaths from smoking-attributable diseases would be averted in 10 years, with subsequent savings on direct and indirect costs of ₦597 billion and increased tax revenue collection of ₦369 billion. In Nigeria, tobacco is responsible for substantial health and economic burden. Increasing tobacco taxes could reduce this burden and produce net economic benefits.

Highlights

  • In 2019, 7.7 million deaths and 200 million disability-adjusted life-years (DALYs) were attributed globally to tobacco [1]

  • This burden corresponds to 816,230 DALYs per year

  • In 2019, the total economic burden attributable to tobacco was estimated at ₦ 634 billion annually

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Summary

Introduction

In 2019, 7.7 million deaths and 200 million disability-adjusted life-years (DALYs) were attributed globally to tobacco [1]. The most populous country in Africa, is currently leading the tobacco market in Africa, with more than 18 billion cigarettes sold annually [2]. The American Cancer Society’s Tobacco Atlas estimated that more than seven million adults are daily smokers in Nigeria for 2015, with more than 300 deaths per week attributable to smoking [3]. Despite recent national initiatives targeted at reducing and regulating the use of tobacco products in the country (e.g., the National Tobacco Control Act of 2015), which in turn reinforces the prerogatives of the World Health Organization Framework Convention on Tobacco Control (WHO FCTC) in 2006 [4], the absolute number of active smokers remains one of the highest in Africa [2]. The smoking prevalence in Nigeria may be declining over the last years, the absolute number of active smokers remains one of the highest in Africa. There is an evidence gap to inform the design and implementation of an effective policy for tobacco control

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