Smoking said to have cost €460m in healthcare in 2013

There are more than 5,400 deaths in Ireland each year due to smoking

* The economic cost of smoking in Ireland is substantial. In 2013, the estimated cost to the healthcare system was over €460 million, the cost of lost productivity was over €1 billion, and the cost of loss of welfare was over €9 billion.

* Stopping smoking substantially reduces the risk of developing most smoking-related diseases and reduces the risk of death. Approximately 28,000 hospital inpatient discharges and 11,000 day cases are due to smoking each year in Ireland. More than 5,400 deaths each year here are due to smoking.

* Most smokers attempt to quit, and most do so more than once a year. According to the 2015 Healthy Ireland survey, half of those attempting to quit smoking in Ireland do so without help. Some 29 per cent of smokers trying to quit use e-cigarettes as an aid. Approximately 16 per cent of quit attempts are made with the help of a pharmacological agent (for example, nicotine replacement therapy [NRT].

* Although all NRT products are available without prescription, to avail of free treatment people with medical cards must have NRT prescribed by a doctor or nurse prescriber. The cost of smoking-cessation prescriptions for other categories of patients are not reimbursed by the State.

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* All pharmacological interventions were found to be more effective when compared with a control group. The prescription drug varenicline was the most effective single therapy, more than 2½ times as effective as control. Varenicline with NRT was the most effective dual-therapy, more than 3½ times as effective as control. E-cigarettes were twice as effective as control but this estimate was based on only two trials with a relatively small number of participants.

* All behavioural therapies were more effective than an alternative of “do nothing”. Group behaviour therapy was the most effective behavioural intervention, being almost twice as effective as brief quitting advice. The effectiveness of pharmacological treatments is improved by an average of 18 per cent with the addition of behavioural therapy.

Muiris Houston

Dr Muiris Houston

Dr Muiris Houston is medical journalist, health analyst and Irish Times contributor