Smoking continues to have a considerable impact on hospital services in Ireland – new study

Smoking and exposure to second-hand smoke (SHS) cost the Irish health service an estimated €172 million in 2016 and resulted in more than 300,000 bed days, almost 21,500 day cases and 33,615 inpatient hospital admissions, a new study has revealed.

The study, which is published in the latest issue of the Irish Medical Journal, used smoking data from the Healthy Ireland Survey, international figures as well as hospitalisation and cost data from the national Hospital inpatient Enquiry (HIPE) database for 2011-2016.

It found that “in 2016, there were 21,486 day case admissions, 33,615 inpatient hospital admissions consuming 309,117 bed days, attributable to smoking and exposure to second-hand smoke, with an estimated cost of €172 million in publicly funded hospitals.”

Furthermore, the study, which was carried out by researchers from the HSE Tobacco Free Ireland Programme, found that these figures represented 2 per cent of day case admissions, 5 per cent of inpatient admissions, and 8 per cent of inpatient bed days for that year.

This led the authors to conclude that, “smoking continues to cause a considerable impact on hospital services in Ireland.”

According to the research, “figures from the World Health Organization (WHO) report that 7 million people die each year as a result of tobacco; more than 6 million of these deaths are as a direct result of smoking, with approximately 900,000 deaths among non-smokers as a result of exposure to second-hand smoke (SHS). In Ireland, in 2016, it is estimated that almost 5,950 people died as a direct result of smoking with an additional 100 deaths estimated to be as a result of exposure to SHS.”

Further analysis revealed that respiratory conditions were the most common reason for smoking-related inpatient hospitalisation in 2016 followed by cardiovascular conditions and cancers.

Meanwhile ‘other conditions’ were the main reason for smoking-related day case admissions, followed by cancers and cardiovascular conditions such as heart disease and stroke.

Coronary heart disease was the most common reason for SHS-related inpatient hospitalisation and SHS-related day case admission.

Overall the research found that “almost one-in-five inpatient admissions for all respiratory diseases, circulatory diseases (heart disease and stroke) and cancers in 2016, were estimated to be attributable to smoking and SHS.”

Interestingly the study found that more men than women were hospitalised for smoking-related diseases, with almost 50 per cent more hospitalisations by males compared to females.

Commenting on the research Mr Chris Macey, Head of Advocacy at the Irish Heart Foundation said, the state needed to do more to help smokers quit.

“This study lays bare yet again the appalling human cost of smoking and the enormous pressure it places on our health system. It is abundantly clear that the price people are paying with their health and the State is paying to treat them could be cut significantly if more was done to help the 80 per cent of smokers who want to quit.

“Currently, the State spends just €11.8 million on smoking cessation measures including medications, smoking cessation services, the national Quitline and mass media campaigns out of around €1 billion that smokers pay annually in additional taxes. It makes absolutely no sense that rather than helping smokers to quit, it’s only after they have a stroke, a heart attack, develop cancer or another serious illness that the State becomes seriously involved in assisting them.”

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(Ir Med J; Vol 113; No. 1; P8 -Counting the Toll of Smoking-Attributable Hospitalisations)