surgeries, other respiratory diseases (pneumonia and bronchitis), other cancers, and tuberculosis are included as major causes of the costs associated with medical care. Data on these costs have been collected based on various academic, national, and international sources.

**Table 6. Total Medical Cost of Tobacco-Related  Cases**

|**Cost item**|_Ischemic disease_|_Stroke_|_Other cardiovascular diseases_|_COPD_|_Other respiratory_|_Lung cancer_|_Other cancers_|_Total_|
|---|---|---|---|---|---|---|---|---|
|Goverment cost<br>(US$)<br>|584|684|438|244|244|633|633||
|Out-of-pocket cost<br>(US$)<br>|389|456|292|163|163|422|422||
|_Tobacco attributed_|||||||||
|Men, %|24|25|25|56|29|91|44||
|Women, %|2|2|2|17|3|27|3||
|Cases, men|32,720|10,069|5,476|6,643|10,766|7,902|2,207|75,782|
|Cases women<br>|3,567|1,222|543|393|1,124|1,099|51|7,999|
|Total tobacco-<br>attributed cases|36,286|11,290|6,019|7,036|11,890|9,000|2,259|83,781|
|Total government<br>cost (US$)|21,191,269.28|7,722,360.00|2,636,370.18|1,716,808.40|2,901,145.36|5,697,101.28|1,429,826.73|43,294,881|
|Total out-of-pocket<br>cost(US$)|<br>4,127,512.85|5,148,240.00|1,757,580.12|1,144,538.93|1,934,096.91|3,798,067.52|953,217.82|28,863,254|

_Note:_ COPD = chronic obstructive pulmonary disease.

**Table 7. Medical Costs of New Tobacco-Related Cases**

|_Indicator_|_Cardiovascular diseases_|_Cardiovascular surgeries_|_Other respiratory_<sup>a</sup>|_Other cancers_<sup>b</sup>|_Tubercolosis_|_Total_|
|---|---|---|---|---|---|---|
|Goverment cost (US$)|90|834|91|633|398||
|Out-of-pocket cost (US$)|60|556|61|422|265||
|Total cases|2,245,864|10,085|312,424|147,074|30,819||
|Tobacco attributed, %|29|29|25|26|9||
|Tobacco attributed cases|651,301|2,925|78,106|38,239|2,774||
|Total goverment cost (US$)|58,617,050|2,439,041|7,107,646|24,205,439|1,103,382|93,472,558|
|Total out-of-pocket cost(US$)|39,078,034|1,626,027|4,738,431|16,136,959|735,588|62,315,039|

_Sources:_ Cardiovascular surgeries, number of procedures: Sokolov et al. Register of percutaneous coronary interventions: a comparative analysis, reperfusion therapy in Ukraine, Survey PKV 2015. Journal Heart and vessels, 2015, issue 3: pages 7–29. Calculation of the average price of one stent was based on public information on the Ministry of Health website on the number of stents in 2017 and the total budget for this purpose (http://moz.gov.ua/ua/portal/pre_20170809_a.html). The market cost of the supplies kit for coronary angiography was taken from the price-list of private clinics, “Clinics of New Technologies,” based at the National Institute of Cardiovascular Surgery, M. M. Amosov, Academy of Medical Sciences of Ukraine, http://www.cnt-amosov.com.ua/index.ukr.php. Costs are taken from “Where the money goes and how to get more with scarce resources in the Ukraine’s health care: Report on findings of PETS/QSDS survey,” joint report of the World Bank, United Nations Development Program, and Kyiv School of Economics, 2017. Tuberculosis data taken from Vassall et al. 2008. a. Pneumonia and bronchitis. b. All other cancers, but lung cancer.

The total estimated out-of-pocket cost of tobacco is over US$90 million, similar to the estimates of the government costs calculated by Denisova and Kuznetsova (2014).

# **e. Summary of descriptive statistics**

Table 8 summarizes the most important indicators, including total monthly expenditure from the household consumption survey and the incidence of household tobacco purchases. The cost of the medical treatment of tobacco-related diseases is estimated as a proportion of monthly income for each income decile. The share of income lost because of years of employment lost resulting from tobacco-related mortality is then estimated.

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