Socio-economic costs of indoor air pollution: A tentative estimation for some pollutants of health interest in France.

An evaluation of the socio-economic costs of indoor air pollution can facilitate the development of appropriate public policies. For the first time in France, such an evaluation was conducted for six selected pollutants: benzene, trichloroethylene, radon, carbon monoxide, particles (PM2.5 fraction), and environmental tobacco smoke (ETS). The health impacts of indoor exposure were either already available in published works or were calculated. For these calculations, two approaches were followed depending on the available data: the first followed the principles of quantitative health risk assessment, and the second was based on concepts and methods related to the health impact assessment. For both approaches, toxicological data and indoor concentrations related to each target pollutant were used. External costs resulting from mortality, morbidity (life quality loss) and production losses attributable to these health impacts were assessed. In addition, the monetary costs for the public were determined. Indoor pollution associated with the selected pollutants was estimated to have cost approximately €20 billion in France in 2004. Particles contributed the most to the total cost (75%), followed by radon. Premature death and the costs of the quality of life loss accounted for approximately 90% of the total cost. Despite the use of different methods and data, similar evaluations previously conducted in other countries yielded figures within the same order of magnitude.

The social cost of drugs in France in 2010.

The social cost of drugs is the monetary cost of both the consequences of their trade and their consumption. In this paper, drugs considered are tobacco and alcohol, which are legal, plus those that are illegal. The social cost is the sum of the external cost: value of loss in quality of life, value of years of life lost and value of loss in productivity, plus public expenditure. Public expenditure consists of public spending on medical care, prevention, and law enforcement, minus savings from unpaid pensions and taxes levied on tobacco and alcohol. The parameters for the calculations have used the recommendations of a French governmental working group (2013) Quinet, L'évaluation socioéconomique des investissements publics [Internet], Centre d'Analyse Stratégique, 2013, http://www.strategie.gouv.fr/sites/strategie.gouv.fr/files/archives/CGSP_Evaluation_socioeconomique_17092013.pdf , and the health data were derived from the scientific literature. The social costs are €122 billion for tobacco, €118 billion for alcohol, and €8.7 billion for illegal drugs. The largest fraction of the costs (53, 56, and 31 %, respectively) derives from the number of deaths, 79,000 for tobacco, 49,000 for alcohol, and 1600 for illegal drugs, given the high cost of a year of life lost (€115,000). The external cost corresponds to 86, 97, and 68 % of the social cost, respectively, for tobacco, alcohol, and illegal drugs. The annual drug-related net expenditure represents €13.9, €3.0, and €2.3 billion, respectively, for tobacco, alcohol, and illegal drugs. The tax revenues on tobacco and alcohol, €10.4 and €3.2 billion, represent less than half of the corresponding healthcare costs, which are €25.9 and €7.7 billion.

An economic analysis of different cannabis decriminalization scenarios.

BACKGROUND: Cannabis is the most widely used illegal drug in European countries. In countries with repressive cannabis policies, prevalence is not lower than in those with tolerant laws. Repressive policies not only have uncertain benefits but they are also expensive. Economists tend to believe that good public policies minimize social costs; that is, they help to improve collective wellbeing at a lower cost. METHOD: The paper draws on a review of international literature on cannabis legislative models around the world. After a description of some of the fundamental concepts of a market economy, several existing policy scenarios will be presented and analyzed from an economic perspective. Strength and weaknesses will be summarized for each alternative. RESULTS: In addition to consumption tolerance in countries such as the Netherlands, recent decriminalization of domestic markets in the Unites States and Uruguay present alternatives to reduce the negative impact of cannabis on society. Earlier initiation age and rise in consumption are unintended potential consequences of decriminalization that need to be addressed by public authorities when designing a liberalized cannabis policy environment. Price is a key variable that needs to be addressed to prevent a rise in consumption. CONCLUSION: Repressive cannabis policies are expensive and have limited impact on consumption. Consumption legalization significantly reduces expenses for repression and law enforcement, allowing for the allocation of more resources to other targets such as education and prevention. With legalization of supply along with consumption, repression and law enforcement costs are reduced even further. Moreover, a legal market would create employment and generate tax revenues that could be allocated to the prevention of increased consumption. Legalizing cannabis would not lead to a sudden rise in consumption, providing the duty imposed by the state kept the product at its current price.

Is life satisfaction hump-shaped with alcohol consumption? Evidence from Russian panel data.

There has been a growing interest in the study of the shape of the relationship between alcohol consumption and psychological well-being in recent years. Overall, evidence is however still mixed and debated, the type of measures and methods of analysis having been emphasized as key elements in these studies. This paper contributes to this debate by providing new evidence relying on a large-scale population-based study. We used the Russia Longitudinal Monitoring Survey to build an unbalanced panel of 17,953 individuals providing 97,973 observations throughout 10 rounds. We studied the shape of the relationship between alcohol consumption (defined in grams of pure alcohol consumed in the last 30 days) and life satisfaction (measured by a five-item scale) by running a set of regressions. We successively introduced a large number of control variables (age, gender, marital status, occupation, income, health condition, education, living area, smoking status, and body mass index) and individual fixed effects in order to take both potential confounders and unobserved individual heterogeneity into account. Unadjusted analyses indicated a clear hump-shaped relationship between life satisfaction and alcohol use. The association was inverse J-shaped among men and inverse U-shaped among women. When control variables and individual fixed effects were introduced, the hump-shaped curve became increasingly flattened in all samples. Among women, all specifications (linear, quadratic and based on quartile dummies) turned non-significant. The quadratic specification for alcohol use remained however significant in the full sample and among men. In addition, in these two samples, being a fourth quartile drinker was negatively associated with satisfaction.

The social cost of alcohol, tobacco and illicit drugs in France, 1997.

UNLABELLED: AIM, DESIGN AND SETTING: The economic costs of alcohol, tobacco and illicit drugs to French society are estimated using a cost of illness framework. MEASUREMENTS: For the cause of disease or death (using ICD-9 categories), pooled relative risk estimates from meta-analyses were combined with prevalence data by age and gender to derive the proportion attributable to alcohol, tobacco and/or illicit drugs. The resulting estimates of attributable deaths and hospitalizations were used to calculate the associated health care, law enforcement, productivity and other costs. The results were compared with those of other studies, and sensitivity analyses were conducted by alternative ways of measuring risk attribution and costs. FINDINGS: The use of alcohol, tobacco and illicit drugs cost more than 200 billion francs (FF) in France in 1997, representing 3714 FF per capita or 2.7% of the gross domestic product (GDP). Alcohol is the drug that gives rise to the greatest cost in France, i.e. 115420.91 million FF (1.42% of GDP) or an expenditure per capita of 1966 FF in 1997. Alcohol takes more than half of the social cost of drugs to society. The greatest share of the social cost of alcohol comes from the loss of productivity (57555.66 million FF), due to premature death (53168.60 million FF), morbidity (3884.0 million FF) and imprisonment (503.06 million FF). Tobacco leads to a social cost of 89256.90 million FF, that is an expenditure per capita of 1520.56 FF or 1.1% of GDP. Productivity losses amount to 50446.70 million FF, with losses of 42765.80 million FF as a result of premature death and 7680.90 million FF linked to morbidity. Health care costs for tobacco occupy second place at 26973.70 million FF. Illicit drugs generate a social cost of 13350.28 million FF, that is an expenditure per capita of 227.43 FF or 0.16% of GDP. Productivity losses reach 6099.19 million FF, with 5246.92 million FF linked to imprisonment and 852.27 million FF to premature death. The cost of enforcing the law for illicit drugs occupies second place at 3911.46 million FF, followed by health care costs of 1524.51 million FF. CONCLUSION: Substance abuse exact a considerable toll from French society in terms of illness, injury, death and economic costs.

Economic and social effects of high-dose buprenorphine substitution therapy. Six-month results.

The purpose of this study was to analyze the impact of high-dose buprenorphine substitution therapy in opiate-dependent patients in terms of use of psychoactive substances, associated risks, social integration, and the social cost generated by the use of these substances. This was a longitudinal quantitative survey carried out in 1083 patients who were evaluated at three times: at the beginning of substitution therapy (D0), at 6 months and then at 12 months follow up (M6, M12). Data were collected with an anonymous self-administered questionnaire, completed in the presence of an investigating physician. Results demonstrated that patients treated with high-dose buprenorphine for 6 months, consumed fewer psychoactive drugs (heroin, cocaine, benzodiazepines) and had fewer associated risks. Additionally, several criteria involved in social integration showed improvement; morbidity and mortality decreased after the first 6 months of substitution therapy. These improvements were followed by a reduction in the social cost of drug use generated by the group of patients considered. These initial results require confirmation in the final analysis of the study taking into account the 12-month follow up.