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20-03-2012 | Cardiology | Article

Morbid obesity costs higher than smoking


Free abstract

MedWire News: The monetary costs of smoking are significantly less than those accrued by the very morbidly obese, say researchers.

Writing in the Journal of Occupational and Environmental Medicine, they report that the mean incremental costs of regular smoking ranged from US$ 1274-1401 (€ 963-1059) depending on age group, compared with US$ 5467-5530 (€ 4135-4182) for people with a body mass index of 40 kg/m2 or above (very morbidly obese).

James Moriarty (Mayo Clinic, Rochester, Minnesota, USA) and colleagues note that the incremental cost of smoking was similar to that of obesity alone (30 kg/m2 or above), but add that costs increased significantly compared with smoking in the morbidly obese (BMI of 35 kg/m2 and above).

The study participants were employees of the Mayo Clinic in Rochester, Minnesota, and their dependents, aged 18 years or older. All the participants (25,022 nonretirees; 5507 retirees) had continuous health coverage between 2001 and 2007.

The team found that over this period, obesity and smoking both substantially increased healthcare costs compared with nonsmoking and being of normal weight.

For smokers, average health costs per year were US$ 1275 (€ 964) higher than for nonsmokers. Compared with normal-weight individuals, the cost discrepancy was even higher for obese or morbidly obese individuals, at up to US$ 1850 (€ 1398) and up to US$ 5500 (€ 4158) per year, respectively.

When 55 categories of comorbidity were adjusted for, the increased costs associated with smoking and obesity decreased dramatically, but were still significantly higher than for nonsmokers and normal-weight individuals.

"In our study, the incremental costs of smoking seem to be about the size of the incremental costs of being obese and lower than in the morbid obesity categories," say Moriarty and team.

Given the large impact of both smoking and obesity on direct and indirect (employee absenteeism, productivity losses, etc.) medical costs, these results should incentivize employers to encourage healthy behaviours in their staff, such as giving up smoking and taking more physical exercise.

"Controlling for comorbidities had a large impact on incremental costs of obesity and could lead to underestimation of the true incremental costs of obesity because obesity is a risk factor for the development of many chronic conditions," stress the authors, concluding that "additional research is warranted to address this issue."

By Helen Albert

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