Canadian Journal of Public Health

, Volume 105, Issue 1, pp e69–e78 | Cite as

The economic benefits of risk factor reduction in Canada: Tobacco smoking, excess weight and physical inactivity

  • Hans KruegerEmail author
  • Donna Turner
  • Joshua Krueger
  • A. Elizabeth Ready
Quantitative Research


OBJECTIVE: Tobacco smoking, excess weight and physical inactivity contribute substantially to the preventable disease burden in Canada. The purpose of this paper is to apply a recently developed approach in addressing the issue of double counting in estimating the combined current economic burden of these risk factors (RFs) and to estimate the economic benefits of long-term RF reduction in Canada.

METHODS: We used an approach based on population attributable fractions (PAF) to estimate the economic burden associated with the various RFs. Sex-specific relative risk and age-/sex-specific prevalence data were used in the modelling when available. Excess weight was modelled as a trichotomous exposure (normal weight, overweight, obese) while tobacco smoking was modelled as a tetrachotomous exposure (non-smoker, light, medium or heavy smoker). All costs are given in constant 2012 Canadian dollars.

RESULTS: The annual economic burden of the RFs of tobacco smoking, excess weight and physical inactivity in Canada are estimated at $50.3 billion in 2012. Sensitivity analysis suggests a range for the economic burden of $41.6 to $58.7 billion. Of the $50.3 billion, $21.3 ($20.0 to $22.6) billion is attributable to tobacco smoking, $19.0 ($1 3.8 to $24.0) billion to excess weight and $10.0 ($7.8 to $12.0) billion to physical inactivity. A 1 % relative annual reduction in each of the three RFs would result in an $8.5 billion annual reduction in economic burden by 2031.

CONCLUSION: A modest annual 1 % relative reduction in the RFs of tobacco smoking, excess weight and physical inactivity can have a substantial health and economic impact over time at the population level.

Key words

Economic burden population attributable fraction risk factors tobacco smoking excess weight physical inactivity 


OBJECTIF: Le tabagisme, le surpoids et la sédentarité alourdissent beaucoup le fardeau des maladies évitables au Canada. Nous avons appliqué une démarche élaborée récemment afin d’aborder le problème du double comptage dans l’estimation du fardeau économique actuel combiné de ces trois facteurs de risque et d’estimer les avantages économiques de la réduction à long terme des facteurs de risque au Canada.

MÉTHODE: Notre démarche se fonde sur les fractions attribuables dans la population (FAP) pour estimer le fardeau économique associé aux divers facteurs de risque. Lorsqu’elles étaient disponibles, nous avons utilisé des données sur le risque relatif selon le sexe et des données de prévalence selon l’âge et le sexe pour la modélisation. Le surpoids a été modélisé en tant qu’exposition trichotome (sujet de poids normal, en surpoids, obèse), et le tabagisme, en tant qu’exposition tétrachotome (non-fumeur, fumeur léger, fumeur moyen, grand fumeur). Tous les coûts sont en dollars canadiens constants de 2012.

RÉSULTATS: Le fardeau économique annuel des facteurs de risque du tabagisme, du surpoids et de la sédentarité au Canada est estimé à 50,3 milliards de dollars en 2012. L’analyse de sensibilité suggère un intervalle de 41,6 à 58,7 milliards de dollars pour le fardeau économique. Sur ces 50,3 milliards, 21,3 (20 à 22,6) sont imputables au tabagisme, 19 (13,8 à 24) au surpoids et 10 (7,8 à 12) à la sédentarité. Une baisse annuelle relative de 1 % de chacun des trois facteurs entraînerait une réduction annuelle du fardeau économique de 8,5 milliards de dollars d’ici 2031.

CONCLUSION: Une modique baisse annuelle relative de 1 % dans les facteurs de risque du tabagisme, du surpoids et de la sédentarité peut avoir un impact sanitaire et économique considérable au fil du temps au niveau de la population.

Mots clés

fardeau économique fraction attribuable dans la population facteurs de risque tabagisme surpoids sédentarité 


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Copyright information

© The Canadian Public Health Association 2014

Authors and Affiliations

  • Hans Krueger
    • 1
    • 2
    Email author
  • Donna Turner
    • 3
    • 4
  • Joshua Krueger
    • 2
  • A. Elizabeth Ready
    • 5
  1. 1.School of Population and Public HealthUniversity of British ColumbiaVancouverCanada
  2. 2.H. Krueger & Associates Inc.DeltaCanada
  3. 3.Department of Community Health SciencesUniversity of ManitobaWinnipegCanada
  4. 4.CancerCare ManitobaWinnipegCanada
  5. 5.Faculty of Kinesiology and Recreation ManagementUniversity of ManitobaWinnipegCanada

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