Smoking status, prevalence of smoking-related diseases and their impact on costs in patients hospitalized in the thoracic units of a tertiary hospital in Brazil

Introduction: Smoking is the leading global risk factor of preventable death, with high costs for the Health-Care System. Aims: To evaluate the prevalence of smoker status and to assess the portion of hospitalizations due to smoking-related diseases, as well as their impact on the total hospitalization costs in our thoracic units. Methods: Patients hospitalized in the Pulmonary Medicine, Thoracic Surgery and Lung Transplantation divisions between February and July 2012 were interviewed about demographics and smoking. Data on the diagnosis and hospitalization costs were supplemented by the hospital’s information sector. A descriptive analysis of the data was performed. Results: 281 patients were interviewed and 344 admissions were recorded. The sample contained 157 never smokers (55,9%), 111 former smokers (39,5%) and 13 smokers (4,6%). Among never smokers and former smokers, 82% and 96%, respectively, had environmental tobacco exposure. Smoking-related diseases were responsible for 45% of all admissions (59% of smokers’ and former smokers’; 35% of never smokers’). Most common smoking related diseases were neoplasms (42,6%; 59% of them were lung cancer), tobacco-related-ILDs (13,5%) and COPD (12,3%). Hospitalizations for smoking-related diseases were responsible for 33% of total costs. Conclusions: This study points to the high prevalence of ever-smokers and environmental tobacco smoke, as well as the high proportion of hospitalizations for smoking-related diseases, even among never smokers. Also alerts to the significant portion of hospital costs for tobacco-related diseases in our thoracic units.