Abu Dhabi anti-smoking programmes do not only save lives - they also save fortunes, study suggests

Programmes helping people to quit smoking in Abu Dhabi can save billions of dirhams that would otherwise be lost because of treatment costs and reduced productivity, a study has found.

The amounts that they save are more than 16 times as much as the cost of the schemes, the analysis by researchers at UAE University has shown.

The large-scale savings suggested in the study come even when the smoking cessation measures are assumed to help just 7.5 per cent of people, or fewer than one in 13, to quit.

“This economic analysis presents robust evidence indicating that the return on investment ratio associated with smoking cessation programmes in Abu Dhabi is considerably favourable,” the researchers wrote.

The study estimated the total savings from the prevention of cases of asthma, cerebrovascular disease (conditions that affect blood flow to the brain and can result in strokes), chronic obstructive pulmonary disease (COPD), heart disease, lower respiratory infections and lung and other cancers.

The authors, based at UAE University, Abu Dhabi Public Health Centre and The Golden Helix Foundation, a London-based charity that supports medical research, calculated the potential annual savings per condition that result from smoking cessation programmes, and multiplied this by the expected lifespan of the patient.

Looking at programmes being provided to a “target population” of 268,869 smokers in Abu Dhabi, it calculated that if Dh539.7 million is spent on quitting programmes, the savings, added over the lifetime of the patients involved, will be Dh8.89 billion, resulting in a net benefit of Dh8.35 billion.

This represents a return on investment – the ratio of the benefit gained compared to the amount spent – of 16.48.

A report last year showed there was urgent need to reduce smoking levels in the region. Data published last year by the World Health Organisation forecasts tobacco-related deaths to increase over the coming decades, including cases of lung and oral cancer, lung condition COPD, heart disease and strokes, unless action is taken.

The study looked at the impact of smoking across seven nations – Pakistan, Egypt, Lebanon, Jordan, Kuwait, Saudi Arabia and the UAE. Of the 390 million people living in the region, about 61 million adults use tobacco. About 384,000 die prematurely each year as a result.

Bigger picture

Dr Bassam Mahboub, a pulmonologist and head of the Emirates Respiratory and Allergy Society, who was not connected to the study, said that smoking cessation programmes offered short and long-term health benefits.

“In the short term it will prevent the asthma attacks, the COPD attacks and it will reduce the cost on the patient,” he said.

“In the long term it will prevent the complications from smoking, which is all the cardiovascular diseases, metabolic diseases like diabetes and hyperlipidaemia and the cardiovascular risk and finally all kinds of cancers from mouth cancers all the way to respiratory cancers and lung cancers.”

Dr Mahboub told The National that in the previous week alone he had seen three young people who had been keen to stop smoking.

“First and the most important intervention is the willingness,” he said. “Then you have to replace the nicotine. Then after that you can talk about something else like antidepressants.”

He said that with older patients, doctors often highlight the risk of cardiac disease and cancers, while with younger patients, messaging centres on issues such as the smell caused by smoking, mouth infections, coughing and limitations on exercise.

One factor that may limit investments in smoking cessation schemes is, the study authors suggest, the fact that the monetary savings they result in are not immediate.

Long-term investment

“While the financial and public health benefits, such as reduced healthcare expenditures and increased productivity, will accrue gradually over time, the initial investment in cessation initiatives requires immediate allocation of resources,” they wrote.

“This discrepancy presents a policy challenge, as decision-makers must navigate short-term fiscal constraints while ensuring long-term societal gains.”

Dr Rachel Kaminski, a pulmonologist who has helped established a smoking cessation programme at Saudi German Hospital in Dubai, said that the study highlighted the cost-effectiveness of smoking cessation. There is, she said, “a massive unmet need” with smoking cessation, treatments and clinics.

She said that patients who came off cigarettes or vapes did not just see improvements in their respiratory or cardiovascular health, but in their general health, with fewer work days missed and lower mortality.

“I know myself that if I've managed to get my patients with severe chronic obstructive pulmonary disease or asthma to stop smoking, their outcomes instantly improve,” she said.

At the smoking cessation clinics Dr Kaminski is involved with, patients receive nicotine replacement treatment, cognitive behavioural therapy and support therapy.

“We know that our patients with chronic diseases, cardiovascular diabetes and respiratory diseases benefit the most from this,” she said.

Dr Mohammed Harriss, a consultant pulmonologist at Medcare Royal Speciality Hospital in Dubai, said that the study suggested that smoking-cessation programmes in Abu Dhabi “generate significantly more financial savings than their costs”.

He said that when patients stopped smoking, they often have fewer flare-ups and hospital visits, reducing the pressure on resources.

“Seeing the financial benefits alongside the health improvements makes a strong case for giving smoking cessation a higher priority within pulmonology services,” he said.

A combination of medication to manage cravings, and behavioural support, which helps patients change habits, s most effective, according to Dr Harriss.

“This approach isn’t difficult to scale in a hospital setting especially when brief advice, referral pathways, and trained staff are built into routine care. Even small interventions during appointments can go a long way,” he said.

Digital platforms and telehealth can support patients outside the hospital, Dr Harriss said, making reminders and follow-up easier and helping patients to stay on track.