Background: Despite that the prevalence of smoking in Australia that has decreased in the past twenty years, the number of smokers in working age population (aged 15 to 64 years) is still high compared to other age groups. While the burden of diseases related to smoking in term of mortality and morbidity has been well studied, the impact of smoking on productivity at population levels has not. Aim: The aim of this study was to estimate the impact of smoking on productivity in Australia, in terms of years of life lost and reduction in productivity in terms of ‘productivity-adjusted life years’ (PALYs) lost.
Methods: Life-table modelling using contemporary Australian data simulated follow-up of current smokers aged 20-65 years until aged 69 years. Excess mortality associated with smoking was based on data published by the World Health Organization. The relative reduction in productivity attributable to smoking (due to both absenteeism and presenteeism) was conservatively assumed to be 1.5% across all ages, as per published data.
Results: At present, approximately 1.9 million Australian (13.9%) aged between 20 to 69 years are smokers. Up until the aged 69 years, 372,973 years of life would be lost to smoking in this cohort, as well as 1.49 million PALYs. These equate to 1.2 % of years of life and 5.0 % PALYs less than if the cohort had been non-smokers. Assuming (also conservatively) that each PALY in Australia is equivalent to USD$50,000, which is the current gross domestic product per capita, the economic impact (excluding healthcare expenditure) of lost productivity would amount to USD$75 billion.
Conclusion: Smoking imposes a significant burden on health and productivity in Australia, highlighting the importance of prevention. PALYs is a novel measure of the impact of smoking (and indeed, any condition) on productivity.