| Summary: | Background
Tobacco consumption precipitates
ill-health and the financial cost of increase in demand for medical care can be
substantial and catastrophic, especially for households in the lowest income
stratum. This paper extends what is known about
the poverty impact of tobacco use by estimating the increased risk of incurring
higher catastrophic health expenditure as a result of tobacco consumption.
Methods
The data for
the study was drawn from the Harmonized Nigerian Living Standard Survey (HNLSS)
conducted in 2009/2010 by the National Bureau of Statistics. In
predicting the health expenditure attributable to tobacco consumption, two
log-linear models of tobacco consumption were estimated. The
experience of catastrophic health expenditure (CHE) was estimated using the standard 40 percent
threshold of household total non-food expenditure.
Results
Smokers had higher health expenditure (46.5% and
44%) compared to non-smokers for the two models estimated. Excess average
health expenditure attributable to tobacco consumption was highest among
smokers that are moderately poor and lowest among non-poor smokers. Also,
extremely poor smokers incurred higher medical expenditure attributable to
tobacco consumption compared to non-poor smokers. Excess medical expenditure
attributable to tobacco consumption increased the burden of CHE by 3.83% among
households living in rural location. Likewise, non-poor households experienced
CHE, 23.87% for households in rural settings and 13.62% for non-poor urban
residents.
Conclusions
Essentially,
due to the sub-optimal nature of health care financing infrastructure in
Nigeria, smoking will aggravate the financial hardship of households as a
result of increase in out-of-pocket payment for health care services in the
short and long run. Therefore, with
health care policy makers battling to increase the coverage of social health
care financing, policies that curtails tobacco consumption are highly supported
by the evidence provided in this study.
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