Smoking and mental health - NCSCT

The economic cost of smoking in people with mental disorders 8
Table 8.2 Relative risks for non-fatal diseases and spontaneous abortion
for current and ex-smokers
Disease caused by ICD-10 code Current smokers Ex-smokers
smoking (r cur
) (r ex
)
Crohn’s disease K50 2.10 1.00
Periodonitis K05 3.97 1.68
Age-related cataract (45+) H25 1.54 1.11
Hip fracture 55–64 S72.0–S72.21 1.17 1.02
Hip fracture 65–74 S72.0–S72.21 1.41 1.08
Hip fracture 75+ male S72.0–S72.21 1.76 1.14
Hip fracture 75+ female S72.0–S72.21 1.85 1.22
Spontaneous abortion O03 1.28 1
(smoking during pregnancy)
Source: Statistics on smoking: England, 2010. 10
reference costs, 21,22 by linking disease ICD codes to the most recent HRG4
groups. 23 From these data we estimate that, in the financial year 2009–10, there
were 2.6 million FCEs among adults aged over 35 with mental health problems
in the UK that were attributable to smoking (Table 8.3).
Applying NHS reference costs to these smoking-attributable inpatient
episodes yields an estimated hospital admission cost of £352m (£166m for
males, £186m for females). Table 8.4 lists the estimated hospital costs by disease
group and gender, and demonstrates (as expected) that malignancy,
cardiovascular and respiratory diseases are the dominant sources of
attributable costs. Figure 8.1 provides the breakdown of costs by mental
disorder, and demonstrates that the great majority of costs arise from people
with anxiety and/or depression.
Table 8.3 Number of hospital admissions by countries: UK 2009–10
Finished consultant FCEs attributable to Source
episodes (FCEs) smoking among people
with mental disorders
England 16,806,196 2,346,078 HES online
Wales 892,655 124,611 PEDW
Scotland 639,111 89,217 ISD Scotland
Northern 583,501 81,454 HSC: Health and
Ireland
Social Care in
Northern Ireland
Sum 18,921,463 2,641,361
© Royal College of Physicians 2013 167