There are more than 45,400 deaths in Canada attributable to smoking, and the habit cost the economy $16.2 billion in 2012, according a new study from the Conference Board of Canada.
Those costs include health care, tobacco enforcement, lost productivity and lost years of life attributable to smoking, with health care alone costing Canada $6.5 billion.
Although Canada's smoking rate is falling, the numbers of deaths and the cost to the economy continue to rise.
'The key message is that we have to continue to look at all age groups and all communities to prevent the start of smoking' — Thy Dinh, Conference Board of Canada
"The impact of smoking is a slow burn," says Thy Dinh, director of health economics and policy at the Conference Board.
So though the smoking rate fell by about 20 per cent from 2005 to 2015, people who began smoking 30 to 50 years ago are still dying. And the big bulge of baby boomers has reached the age when a lifetime of smoking is starting to show its effects.
"That mortality is going to go down but it takes decades to see the impact of changes in behaviour," Dinh said.
In 2015, about 18 per cent of the population smoked cigarettes, down from 22 per cent a decade earlier.
18% of all deaths attributable to smoking
The last study of the overall costs and mortality of smoking in Canada was 10 years ago, using figures from 2002. At that time, the number of deaths attributable to smoking was 37,209, but by 2012, the year used for the current study, mortality had risen to 45,464 across Canada. That's 18 per cent of all 2012 deaths and includes 993 deaths caused by second-hand smoke..
The most likely causes of death remained unchanged: cancers, cardiovascular diseases and respiratory diseases. But by 2012, more health problems were seen as part of the impact of smoking because experts had confirmed the link between smoking and conditions such as macular degeneration, diabetes mellitus, tuberculosis, liver cancer and colorectal cancer
Death and illness related to smoking continued to mount over the decade even though some people may be living longer because of better cancer treatments, Dinh said.
"We're living longer, but are we living better?" she asked.
More men than women were dying: 58.5 per cent of all smoking-related deaths were men.
The costs to the Canadian economy add up, among them:
- Hospital care, $3.8 billion.
- Prescription drugs, $1.7 billion.
- Physician care, $1 billion.
- Fire damage, $74.4 million
- Tobacco research and prevention, $10.7 million
- Tobacco control and law enforcement, $122 million
But the biggest costs were the loss to families of having a breadwinner die or become disabled because of a smoking-related illness and the productivity loss to employers of losing a worker to a smoking-related condition.
Loss of productivity, income
Forgone earnings as a result of smoking-attributable premature death and illness was estimated at $9.5 billion, and the cost of short and long-term disability was $7 billion. Those who became ill while in the workforce lost an average of seven years of their productive work life, the study found.
In 2012, 599,390 potential years of life were lost because of smoking, meaning smoking knocked an average of 13 years off the life of people who became ill.
The cost to the economy of losing someone over age 65, who is unlikely to be in the workforce, is lower, Dinh said, but almost 25 per cent of those affected by smoking related illnesses are of working years.
"The key message is that we have to continue to look at all age groups and all communities to prevent the start of smoking," she said. "We have to ask, how can we support smokers who want to quit."
That includes niche communities where smoking rates are high, such as among construction workers, she said.