17 Jan 2014

The Actual Cost of Smoking

I am one of the typical Bangalore commuters. My office is a two hour commute (one way) during peak hour traffic. During the long, bumpy drive; I notice a lot of bus stops, junctions and markets where people of all age groups are smoking. This made me wonder - what is the actual cost of smoking ?

In all honesty, I had no idea about the numbers. I was a little embarrassed to walk to the panvala and ask.   I asked around at office. Some guys were willing to share the information. A cigarette with a filter costs around Rs.8. There are ten cigarettes to a pack and the cost per pack is Rs.80. The expensive brands cost around Rs.200 to a pack. Even if a person smokes two cigarettes a day costing Rs.8 each, he or she spends Rs. 480 a month. On average, a smoker in my office spends Rs. 1000 a month on cigarettes which is Rs.12,000 per annum

Now that I am done with the cost of cigarettes per pack, let us discuss the real cost of smoking. A smoker is at greater risk for a heart attack, diabetes, lung cancer, COPD (Chronic Obstructive Pulmonary Disease), asthma, hypertension, infections, dental trouble etc. Let us say, a smoker develops asthma. Asthma is a terrible disease where one cannot breathe because the airways feel constricted. A regular medication prescribed for asthmatics is albuterol inhaler which opens up the airways when they are short of breath. The inhaler costs around Rs.70 and is used on an as needed basis. If a smoker uses around two and a half inhalers a month, the cost is Rs.175 a month which comes to Rs.2100 a year. This added to the cost of cigarettes is Rs.14,100 a year. A smoker is more prone to infections and cold and cough. Every time the season changes, he or she is more prone to catching a cold. Let us say a smoker needs cold medications four times a year. If he spends Rs.100 on cold medications every times he catches a bug, the cost is Rs.400 per annum. This brings our annual cost to Rs.14,500.

If a person continues smoking and develops diabetes the cost has increased manifold. He now needs visits to the endocrinologist regularly, he needs test strips, a glucose monitor and medications. Visits to the doctor are between Rs.200 and Rs.500 a sitting, test strips are Rs.1245 for a pack of 50 test strips, medications can be anywhere between Rs.100 to Rs.500 for a month's supply. Assuming four trips to a medical doctor (Rs.300 per consultation) in a year, one box of 50 test strips a month and medication Rs.100 a month; the annual cost comes to Rs. 17,340. Total annual cost is Rs.14,500 (cost of cigarettes, cold medications and inhalers) + Rs.17,340 = Rs.31840. If the same person has a heart attack, just the hospitalization and procedures will be in the range of Rs.2,00,000 to Rs.5,00,000. The maintenance after that becomes even more expensive.

Smoking creates a cascade of events which make smoking and lifestyle very expensive. I have not yet included the cost of second hand smoke. Children who are brought up in a house where someone smokes are prone to respiratory infections, cold and cough, cardiovascular impairment

So how does one quit ? There are many options to quit. Yes, quitting is difficult and requires a lot of commitment. But it is worth it.

1. Cold Turkey - A lot of patients I know took this route. One interesting fellow quit cold turkey but did not throw away his packs, Instead, he gave all his packs to his wife who would yell at him every time he asked for a cigarette. He made four quitting attempts before he won and now he has been "smoke free" for two years.

2. Nicotine gum and patches. - There are nicotine replacement gums and patches available at pharmacies. These have clear directions as to how to use them. Some patients say it helps and some look at it as an annoyance.

3. Substitute - Many patients tell me that this works for them. Whenever they feel like smoking, they call a friend, suck on a piece of chocolate, take a walk, have a cup of tea etc. They distract themselves by substituting the activity with another one.

4. Chantix - This is a medication which many people swear by. The generic name is called varenicline. Patients have confided in me saying that it really makes you not want to smoke but one has to be careful once they stop the medication.

Please talk to your doctor before beginning any medication.

 There are many reasons to quit smoking. Financial reasons, your own health, health of your near and dear ones etc. If financial reasons give you a kick, start by putting the money you spend on cigarettes in a recurring deposit. One can easily find an RD @ 9 %.. Save the money and see it grow. Because you see, winners never quit but quitters do win.

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