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Objective: To assess the health-related economic burden attributable to smoking in China for persons aged 35 and older. Methods: A prevalence-based, disease-specific approach was used to estimate the smoking attributable direct costs, indirect morbidity costs, and costs of premature deaths caused by smoking-related diseases. The primary data source was the 1998 China National Health Services Survey, which contains the smoking status, medical utilisation, and expenditures for 216 101 individuals. Results: The economic costs of smoking in 2000 amounted to $5.0 billion (measured in 2000, US$) in total and $25.43 per smoker (> age 35). The share of the economic costs was greater for men than women, and greater in rural areas than in urban areas. Of the $5.0 billion total costs, direct costs were $1.7 billion (34% of the total), indirect morbidity costs were $0.4 billion (8%), and indirect mortality costs were $2.9 billion (58%). The direct costs of smoking accounted for 3.1% of China's national health expenditures in 2000. Conclusion:The adverse health effects of smoking constitute a huge economic burden to the Chinese society. To reduce this burden in the future, effective tobacco control programmes and sustained efforts are needed to curb the tobacco epidemic and economic losses.

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Objectives:To analyse differences in smoking behaviour and smoking expenditures among low and high income households in China and the impact of smoking on standard of living of low income households in China.Methods:About 3400 urban and rural households from 36 townships/districts in southwest China were interviewed in 2002. Cross tabulations and regression analysis were used to examine the differences in major household expenditures, including food, housing, clothing, and education between households with smokers and without smokers.Results:Lower income households with smokers paid less per pack and smoked fewer cigarettes than higher income households with smokers. Poor urban households spent an average of 6.6% of their total expenditures on cigarettes; poor rural households spent 11.3% of their total expenditures on cigarettes.Conclusion:Reducing cigarette expenditures could release household resources to spend on food, housing, and other goods that improve living standards.

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