Dear Editor,

Although tobacco smoking is an independent risk factor for cerebrovascular disease (CVD) [1, 2], CVD health-care costs generated by smoking remain unknown in many countries [3, 4], including Mexico [5]. To estimate the direct health-care cost of CVD from a provider's perspective, we conducted a cost of illness (COI) analysis using data from the medical records of patients who visited the Mexican National Institute of Neurology and Neurosurgery in 2010. Cost estimates in Mexican pesos were converted into US dollars using the 2010 FIX exchange rate for foreign transactions. The fraction of CVD costs attributable to smoking was used to estimate the costs of smoking.

The total cost of smoking-attributable CVD at our center in 2010 was $1 179 607. The average annual cost per patient by CVD type was $3904 for ischemic stroke, $6098 for hemorrhagic stroke, $2416 for cerebral venous thrombosis, and $11 477 for subarachnoid hemorrhage. The medical care costs of newly diagnosed with CVD patients are mainly attributable to immediate care in the emergency room and initial hospitalization, when the patient is stabilized and diagnostic tests are conducted (Fig. 1). This study in a developing country confirmed the high direct medical care costs of patients with CVD attributable to smoking. Implementing the WHO Framework Convention of Tobacco Control should work to reduce these costs.


Figure 1. Percentage frequency distribution of total costs by type of event and type of cerebrovascular disease.

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  2. References
  • 1
    Paul SL, Thrift AG, Donnan GA. Smoking as a crucial independent determinant of stroke. Tob Induc Dis 2004; 2:6780.
  • 2
    Galimanis A, Mono ML, Arnold M et al. Lifestyle and stroke risk: a review. Curr Opin Neurol 2009; 22:6068.
  • 3
    CDC. Smoking-attributable mortality, years of potential life lost, and productivity losses United States, 2000–2004. MMWR Morb Mortal Wkly Rep 2008; 57:12261228.
  • 4
    Sloan FA, Ostermann J, Conover C, Taylor DH, Picone GJ. The Price of Smoking. Cambridge, MA, The MIT Press, 2006:1305.
  • 5
    Reynales-Shigematsu LM, Rodríguez-Bolaños RdeL, Jiménez JA et al. Health care costs attributable to tobacco consumption on a national level in the Mexican Social Security Institute. Salud Pública Mex 2006; 48:S4864.