الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
The study is considered one of the pioneer tobacco economic studies in Egypt that involved in estimation of Smoking Attributable Fraction (SAF) and Smoking Attributable Expenditure (SAE) and it is a novel approach to prompt smoking cessation emphasizing cost analysis of its cardiovascular risk.
The effect of cigarette smoking on cardiovascular health is evident even at the lowest levels of exposure and the evidences are not only sufficient to infer a causal relationship between tobacco smoke and (CVDs).
The smoking prevalence in Egypt is considered as a public health problem as it increased from 18% in 2006 to 24.4% in 2012 for both sexes, and among males it increased from 34.6% to 46% and in our study the prevalence of smoking was 51.6% for the petroleum refinery employees, these numbers showed the need to enforce stronger tobacco control measures to reduce health and financial losses caused by smoking.
The Study was conducted at a Petroleum Refinery in Alexandria and the study design was a Cross sectional study design and included all male employees above 35 years old (283 employees).
The Personal records of the employees were collected from the human resource department during the year 2013. And the health records of the employees suffering from cardiovascular diseases collected from the medical section of the petroleum refinery according to the local health insurance payment system.
The results of the study revealed that SAF for the CVDs was 26.2% which was very high if compared with the SAF in other countries which closed to Egypt in the smoking prevalence, such as India that SAF representing 15%, And SAE comprised 109,005 Egyptian Pounds which represented approximately one quarter of the Total Health care Expenditure (THE) spent on CVDs.
As a measure of the total indirect cost, it was 55,296 L.E which meant that the petroleum refinery lost 55 Thousands Egyptian pounds only due to sickness leaves attributed to smoking for CVDs.
All these facts and results require strong interventions and key strategies should be implemented for effective tobacco control measures including Monitoring, Protecting, helping and Enforcing.