Analysis Of Economic Burden Of Major Respiratory Diseases Attributable To Tobacco Exposure In Fu Min County Of Yunnan Province

Objective This study aims to estimate the prevalence, direct and indirect economic burden of the major respiratory diseases in Fu Min County of Yunnan province, and to measure economic burden of the major respiratory diseases attributable to tobacco exposure. The findings can provide a theoretical basis for preventing major respiratory diseases and decreasing the economic burden of COPD and asthma.Methods Probability proportional to size (PPS) sampling method was used to select representative sample of residents aged 18 years and over from Fu Min county. Information was obtained from a cross-sectional questionnaire survey. Two-steps method and human capita method were used to measure direct and indirect economic burden of the major respiratory diseases. The total economic burden of the major respiratory diseases is the sum of direct and indirect economic burden. All statistical analysis were done using SPSS 17.0 software.Results We collected 4275 valid questionnaires, with a response rate of 95%. The overall prevalence of COPD and asthma were 1.94% and 1.29%, respectively. The prevalence of COPD and asthma was 2.09% and 1.07% for males, whereas was 1.80% and 1.49% for females. There was no significant difference of prevalence of COPD and asthma between men and women (P>0.05). Prevalence of COPD and asthma increased with age (P<0.01),The highest prevalence of COPD and asthma was found among the widowed group (3.86%, P<0.05). The families with low-income had higher prevalence of COPD than the high-income families, but there was no significant difference of prevalence of asthma between low-income and high-income families(P>0.05).The prevalence of smoking and secondhand smoke exposure (SHS) were 35.4% and 40.6%, respectively. Among males, smoking rate and passive smoking rate were 72.4% and 33.4%, whereas was 0.9% and 42.8% for females. Males had obviously higher smoking rate than females (P<0.01), whereas females hsd higher prevalence of passive smoking rate than males (P<0.01). Prevalence of Smoking increased with age (P<0.05). High-income families have higher smoking rate (p<0.01). There was no significant difference of passive smoking rate between low-income families and high-income families(P>0.05).Smokers and people exposure to SHS had higher prevalence of COPD and asthma than their counterparts (P<0.05). There was a strong association between smoking (OR=1.72) and SHS (OR=5.56) and risk for COPD, and there was a strong association between smoking (OR=4.63) and SHS (OR=5.58) and risk for asthma.If removed smoking and SHS, the rate of COPD could decreased 20.2% and 65.0%,and the rate of asthma could decreased 56.2% and 66.4%,respectively.Per capita direct and indirect economic burdens of COPD were 6452.95 yuan (7266.45yuan for male,6049.74yuan for female) and 9913.37 yuan (5633.44 yuan for male,4674.40 yuan for female), the per capita direct and indirect economic burdens of asthma were 8836.38 yuan (5917.23yuan for male,10160.18 yuan for female) and 6433.89 yuan (3147.36 yuan for male,1923.24 yuan for female) in Fu Min County of Yunnan province. The total economic burden of COPD was 46.21 million Yuan.The total direct economic burden and indirect economic burden of COPD were 18.22 million and 27.99 million. The total economic burden of asthma was 27.79 million Yuan.The total direct economic burden and indirect economic burden of asthma were 15.71million and12.08 million.The economic burden of COPD attributed to smoking was 9.33 million (11.27 million yuan for male,1.92 million yuan for female). The economic burden of COPD attributed to SHS was 46.21 million (20.01million yuan for male,13.84 million yuan for female).The economic burden of asthma attributed to smoking was 15.62 million (2.13 million yuan for male,1.72 million yuan for female). The economic burden of asthma attributed to SHS was 15.62 million (2.13 million yuan for male,8.99 million yuan for female).Conclusion Smoking and passive tobacco exposure has made the prevalence of COPD and asthma increased significantly in Fu Min County of Yunnan province. It influences Fumin rural residents’health, causes a large of economic burden, and wastes a lot of health recourses. It should enhance health education of quitting smoking among rural residents and reduce the rate of smoking and passive smoking, so as to help reduce the economic burden of COPD and asthma in the study region.