Thursday, 4 February 2010

Smoking by numbers.

How much does smoking cost the NHS? So many figures get bandied around that I'm never sure, but I think it's claimed to be about £3 billion, or under a third of the revenue take from cigarette sales.

Smoking cuts the risk of Alzheimer's. The study is about 20 years old and if I can find it, assuming it hasn't been expunged from history, I'll post a link. It could be due to nicotine's effects in the brain or it could simply be that fewer smokers get old enough to suffer it. Either is fine with me. If clinging to a few more years of life means thinking I'm a boiled egg and living in terror of teaspoons, I don't want it.

The thing is, dementia (including Alzheimer's) is soon going to cost the NHS £23 billion a year. Cancer costs £12 billion and heart disease £8 billion. That's all cancers and all heart disease, not just the much hyped 'smoking' ones. The smoking ones are around a tenth of that total.

So let's recap. Smoking costs £3 billion but brings in £10 billion. If we all stop smoking the NHS gains £3 billion but loses £10 billion, a net loss of £7 billion.

Cancer and heart disease costs will drop from £20 billion to over £17 billion (there are so many smoking-related diseases now, not just cancer, that the effect of all smokers stopping on total cancer rates would be negligible).

But wait, there's more.

Two million smokers will get older than they would have. Pension costs will go up. Old age care costs will go up. More hip replacements, more false teeth, more of every illness of old age.

That projected £23 billion cost for dementia will also go up.

So all this 'cost of smoking' argument is looking pretty thin. Aside from the lost revenue, the effect of removing 'smoking-related' from the list of diseases will have a negligible effect on their total cost and the cost of dementia care will increase too.

Overall, the NHS gets a good deal out of smokers. We cost one-tenth of the price of those healthy people who live to a ripe old age, even though they've forgotten why. We pay in three times as much as we cost, but there's no tax on dementia so they pay in nothing above the NI and tax we smokers also pay.

So can we lay to rest the 'smokers cost us money' nonsense at least? I know the more rabid antismokers will still complain about 'the smell' which they can't possibly experience indoors anyway any more, but at least stop pretending you're subsidising our healthcare.

The fact is, we're subsidising yours.


Captain Ranty said...

And then there was the Dutch study which found that lifetime (NHS) costs for the "healthy" were £315K, the obese cost £275K to treat and the smokers?


The financial argument really does not work well for the Righteous.


Giolla said...

Thought this may amuse you:

A mobile phone with built in cigarette lighter.

Captain Ranty said...


The REAL challenge these days is to find a new car with a built in ashtray.


Although I do like the phone/lighter idea.

Anonymous said...

I remember a few years back when I was doing a lot of work in Bavaria that my contact drove a VW Passat Estate and smoked like a chimney.

His ashtray was always full to overflowing and was the feature of conversation whenever I enteered the car; different brands, the odd lipstick on some fag ends etc.

He changed cars to the new Passat Estate and out of friendship swapped the old ashtray into the new car.

He had a heart attack some few months later and had to stop the fags. He kept on the beer though as in Bavaria beer is classified as food.

Obnoxio The Clown said...


JuliaM said...

Wondered if you'd seen this? Just Tweeted by Charlotte Gore.

You said the day would come...

View from the Solent said...

re JuliaM

Time for a mega-bulk order from eCigCo. And a look through the just-published details of who's schmoozing who at the House of Commmons to see who the maufacturers of nicitine patches and gum have bought.

Anonymous said...

e-cigarettes are already illegal in Canada and I have no problems buying and sourcing supplies on the web (Thanks to the ingenious Chinese immigrant population). It should be even easier to do this in the UK. In canada we have to rely on the "politically correct" native indian population for our supply of contraband smokes (The government is scared of messing with them).

It will be interesting to see what happens with e-cigarettes using liquids that do not contain tobacco related ingredients. Quite a few Canadians and Americans use these (although no one can tell by just sniffing and looking).

I think this is all a conspiracy whereby Chelsea, Arsenal, Liverpool and Man City fans are hell bent on trying to slow down Wayne Rooney by restricting his access to performance enhancing cigarettes.

Expat Canadian

English Pensioner said...

I've been making this argument for years although I'm a non-smoker. As I get older, I realise that most of the people that I knew who have since died all spent some time receiving fairly intensive treatment over the months or years before they died. This happened with all except the few who dropped down with heart attacks. So it seems, whether we die as a result of a smoking related illness or lead a so-called healthy life and then die of hospital acquired MRSA following a fall, we will all require treatment during our final years, probably at very similar cost.
Meanwhile those of us who soldier on require continuous NHS treatment in the form of Blood pressure pills, statins, flu jabs, etc even if we are nominally healthy. And of course, there is the cost of my pension, heating allowance, free bus pass, etc.
So although it is good to encourage a healthy life style, it is totally wrong to insist it saves the state money

Pogo said...

"It's a truism that at present there is far more money spent on boob-jobs and Viagra than is spent on research into Alzheimer's. The result is going to be that in 40 years or so there's going to be loads of old people with either perky boobs or firm erections and not the foggiest idea of what to do with them!".


timbone said...

haha here is the sum I worked out, similar. Smokers cost the NHS 2.7 billion a year and contribute 9 billion to the coffers which leaves 6.3 billion change towards the 23 billion for those who gave up smoking.

Anonymous said...

Wouldn’t it be good if, “in order to avoid the constant drain on the NHS from smoking-related illnesses” (their words, not mine) the authorities used the £9 billion that they make each year to build, equip and run separate hospitals just for smokers? With only 20-odd percent of the population being smokers, they wouldn’t need anywhere near as many as they do to cater for the rest of the population, and they wouldn’t need to be so enormous, either – they could be more like the old-style cottage hospitals which have now all but vanished. How much does it cost to build and equip a small hospital? I would guess that half a billion apiece at the very most would do it, so that would be 12 built in the first year alone. And to run? Well, let’s say £10 million a year. That’s £120 million to run the lot. Even if my figures are way out and you double everything, it still leaves an enormous surplus to go towards patient facilities, research, new equipment, better staff - just think of the food, the private rooms, the top-flight treatments, the cleanliness. Think, too, of the attractions for all types of medical staff of working in such an environment. So many would want to get in that only the very, very best would be successful – so we’d have the cream of the crop there, too. And, as anti-smokers wouldn’t dream of working in such a den of sin and vice, there’d be no problems with compulsory lifestyle lectures or PC rules about smoking shelters etc. Result!

And all at no cost at all to all those healthy non-smokers, who would now have all those cramped, under-funded, MRSA-infested NHS hospitals all to themselves.

Of course, we’d probably all have to pay more general taxes to make up the shortfall of money which is currently used to build bridges, fund schools and repair roads, but with our own health service, funded by ourselves, smokers would surely then have a good reason to put a legal case for “opting out” of NI payments, which would compensate for the extra tax we’d have to pay on other things. After all, to parrot the whining of the antis, if we were funding our own health service and no longer had any need to use the NHS: “Why should we then subsidise their health service?”

I think it’s such a brilliant idea that I’m amazed that some anti-smoking zealot hasn’t already thought of it. Hmmmm, wouldn’t possibly be because maybe, just maybe, all this spouting on about the “cost of smoking” is – well - plain old-fashioned lies?? No, surely not?

Simon said...

Ah you did see Obo's post then!

I blogged on this last year
- here are a few stats from the NHS, ONS and HMCR:
# Treating illnesses and disease associated with smoking costs the NHS between £1.4bn and £1.5bn a year
# Make your money through patches - Cost of Stop Smoking Services: £61m
# £3bn is lost in revenue through tobacco smuggling
# Since 1996 (just) duty on cigarettes has risen 70% around 93p a packet
# Taking inflation into account and the rise in household income the cost of tobacco products has gone up by 143% making it 17% less affordable
# Household expenditure on tobacco has more than trebled to £16.6bn despite volumes dropping since 1980

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