Burden of Cancers Related to Smoking among the Indonesian Population: Premature Mortality Costs and Years of Potential Life Lost

  • Kristina, Susi Ari (Management and Community Pharmacy Division, Faculty of Pharmacy, Gadjah Mada University) ;
  • Endarti, Dwi (Management and Community Pharmacy Division, Faculty of Pharmacy, Gadjah Mada University) ;
  • Prabandari, Yayi Suryo (Public Health Department, Faculty of Medicine, Gadjah Mada University) ;
  • Ahsan, Abdillah (Demographic Institute, Faculty of Economics, University of Indonesia) ;
  • Thavorncharoensap, Montarat (Social and Administrative Pharmacy Department, Faculty of Pharmacy, Mahidol University)
  • Published : 2015.11.04


Background: As smoking is the leading preventable cause of multiple diseases and premature cancer deaths, estimating the burden of cancer attributable to smoking has become the standard in documenting the adverse impact of smoking. In Indonesia, there is a dearth of studies assessing the economic costs of cancers related to smoking. This study aimed to estimate indirect mortality costs of premature cancer deaths and years of potential life lost (YPLL) attributable to smoking among the Indonesian population. Materials and Methods: A prevalence based method was employed. Using national data, we estimated smoking-attributable cancer mortality in 2013. Premature mortality costs and YPLL were estimated by calculating number of cancer deaths, life expectancy, annual income, and workforce participation rate. A human capital approach was used to calculate the present value of lifetime earnings (PVLE). A discount rate of 3% was applied. Results: The study estimated that smoking attributable cancer mortality was 74,440 (30.6% of total cancer deaths), comprised of 95% deaths in men and 5% in women. Cancers attributed to smoking wereresponsible for 1,207,845 YPLL. Cancer mortality costs caused by smoking accounted for USD 1,309 million in 2013. Among all cancers, lung cancer is the leading cause of death and economic burden. Conclusions: Cancers related to smoking pose an enormous economic burden in Indonesia. Therefore, tobacco control efforts need to be prioritized in order to prevent more losses to the nation. The data of this study are important for advocating national tobacco control policy.


Smoking;cancer;YPLL;premature mortality cost;Indonesia


  1. Akaza H, Kawahara K, Nozaki S, et al (2015). Roundtable discussion at the UICC World Cancer Congress: Looking toward the realization of universal health coverage for cancer in Asia. Asian Pac J Cancer Prev, 16, 1-8.
  2. Centers for Disease Control and Prevention (CDC) (2008). Smoking-attributable mortality, years of potential life lost, and productivity losses-United States, 2000-2004. MMWR Weekly, 57, 1226-8.
  3. Ezzati M, Lopez AD (2004). Regional, disease-specific patterns of smoking attributable mortality in 2000. Tob Control, 13, 388-94.
  4. Ferlay J, Shin HR, Bray F, et al (2010). Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer, 127, 2893-917.
  5. Gandini S, Botteri E, Iodice S, et al (2008). Tobacco smoking and cancer: A meta-analysis. Int J Cancer, 122, 155-64.
  6. Hanly P, Pearce A, Sharp L (2014). The cost of premature cancerrelated mortality: a review and assessment of the evidence. Expert Rev Pharmacoeconomics Out Res, 1-23.
  7. Jan S, Kimman M, Kingston D, et al (2012). The socioeconomic burden of cancer in member countries of the Association of Southeast Asian Nations (ASEAN) - Stakeholder meeting report. Asian Pac J Cancer Prev, 13, 407-9.
  8. Khorasani S, Rezaei S, Rashidian H, et al (2015). Years of potential life lost and productivity costs due to premature cancer-related mortality in Iran. Asian Pac J Cancer Prev, 16, 1845-50.
  9. Kimman M, R N, Jan S, et al (2012). The burden of cancer in member countries of the Association of Southeast Asian Nations (ASEAN). Asian Pac J Cancer Prev, 13, 411-20.
  10. Mathers CD VT, Lopez AD, Salomon J, Ezzati M (ed.) 2001. National Burden of Disease Studies: A Practical Guide, Geneva: World Health Organization.
  11. Oh I, Yoon S, Yoon T, et al (2012). Health and economic burden of major cancers due to smoking in Korea. Asian Pac J Cancer Prev, 13, 1525-31.
  12. Park S, Jee SH, Shin H, et al (2014). Attributable fraction of tobacco smoking on cancer using population-based nationwide cancer incidence and mortality data in Korea. BMC Cancer, 14.
  13. Sung HY, Wang L, Jin S, et al (2006). Economic burden of smoking in China, 2000. Tobacco Control, 15, 5-11.
  14. Thun MJ, DeLancey JO, Center MM, et al (2010). The global burden of cancer: priorities for prevention. Carcinogenesis, 31, 100-10.
  15. World Health Organization. 2010. Global Health Observatory Data Repository. LIfe expectancy: Life tables Indonesia [Online]. Geneva: WHO.
  16. Yang L, Sung H, Mao Z, et al (2011). Economic costs attributable to smoking in China: Update and an 8-year comparison, 2000-2008. Tob Control, 20, 266-72.

Cited by

  1. Estimating the Burden of Cancers Attributable to Smoking Using Disability Adjusted Life Years in Indonesia vol.17, pp.3, 2016,
  2. Health Care Cost of Noncommunicable Diseases Related to Smoking in Indonesia, 2015 vol.30, pp.1, 2018,