OBJECTIVES

Children exposed to secondhand smoke (SHS) are at increased risk for diseases. We sought to estimate costs and health outcomes for Korean children who were exposed to SHS at home.

METHODS

A Markov model was developed to project the health and economic outcomes of a hypothetical cohort of Korean newborn infants who’s at least one of family member is current smoker. Increased risk of asthma, acute otitis media (AOM), acute bronchitis, pneumonia, and SIDS were included in the model, since they were significantly associated with SHS in children based on systematic review. The time horizon of the analysis was 20 years (from birth to adulthood) and the cycle length was 1 week. The direct healthcare costs and QALYs were annually discounted at 5%. The validity of the model was evaluated by comparing the odds ratio of the AOM and pneumonia estimated from our model. Probabilistic sensitivity analysis (PSA) was conducted on the increased risk of the SHS exposure using log-normal distribution.

RESULTS

Base case analysis showed that the exposed group’s costs and QALYs were 643.21 USD and 636.01 QALYs, respectively, which was 156.47 USD higher and 2.43 QALYs lower than the non-exposed group. In all of the diseases included in the model, the costs increased when exposed to SHS. In particular, AOM had the largest cost increase compared to the unexposed group (18.52USD, 143.35%), and the disease with the largest absolute cost increase was pneumonia (84.41USD). Our model slightly underestimated for pneumonia and overestimated for AOM, based on the validity study.

CONCLUSIONS

The increase in healthcare costs was noticeable, especially in AOM and pneumonia. This study conservatively approached the effects of SHS exposure on children, because we simulated the period from birth to adulthood, and did not take into account the disease that occurs after adulthood.