Health Care Costs Attributable to Tobacco in Cambodia

In developing countries like Cambodia, it is often assumed that the cost of tobacco-related disease to national economies and households is low, despite a high number of male smokers. There are a number of reasons for this. Reporting of tobacco-related disease is low. Treatment for anything other than infectious disease or trauma is often unavailable.

Cambodian policymakers have expressed the need for convincing and reliable information on the health costs of smoking, particularly in light of the draft tobacco control law, which is due for Parliamentary approval, and an upcoming tobacco taxation increase.

This research project will generate knowledge about the direct healthcare costs of active tobacco use and the indirect productivity losses of active tobacco use. Researchers will examine the costs associated with five disease groups:

  • lung cancers;
  • tuberculosis (TB);
  • ischemic heart disease;
  • stroke (cerebrovascular disease); and,
  • chronic obstructive pulmonary disease.

They will not estimate the costs associated with second-hand smoke, the cost of tobacco purchase, or the cost of using tobacco products which are not smoked.

There is strong evidence from other countries that smoking increases the TB infection rate and reduces tuberculosis survival rates. Cambodia has high TB and smoking rates, so the cost of tobacco use will also include the cost of excess tuberculosis-related deaths.

Cambodia's health information systems are weak and unreliable. As a result, data will be collected only in major health facilities located in Phnom Penh and large regional facilities. Local health information databases and health service personnel will help establish the annual number of cases. Researchers will determine the costs per case through surveys and interviews with health personnel. They will calculate the indirect costs due to productivity losses using secondary data on World Health Organization disability adjusted life year estimates. They will also conduct a small number of case studies to determine the costs of treatment and care of tobacco-caused disease to individuals and families.

Project ID


Project status


Start Date

Friday, September 27, 2013

End Date

Thursday, December 31, 2015


24 months

IDRC Officer

Hallen, Greg

Total funding

CA$ 67,400


Cambodia, Far East Asia, Central Asia, South Asia


Food, Environment, and Health

Project Leader

Daphea Chhea


Cambodia. Ministry of Health. National Center for Health Promotion

Institution Country


Institution Website