Smoking, life expectancy, and chronic disease in South Korea, Singapore, and the United States: A microsimulation model

Daejung Kim, Cynthia Chen, Bryan Tysinger, Sungchul Park, Ming Zhe Chong, Lijia Wang, Michelle Zhao, Jian Min Yuan, Woon Puay Koh, Joanne Yoong, Jay Bhattacharya, Karen Eggleston

Research output: Contribution to journalArticlepeer-review

9 Scopus citations


The substantial social and economic burden attributable to smoking is well-known, with heavy smokers at higher risk of chronic disease and premature mortality than light smokers and nonsmokers. In aging societies with high rates of male smoking such as in East Asia, smoking is a leading preventable risk factor for extending lives (including work-lives) and healthy aging. However, little is known about whether smoking interventions targeted at heavy smokers relative to light smokers lead to disproportionately larger improvements in life expectancy and prevalence of chronic diseases and how the effects vary across populations. Using a microsimulation model, we examined the health effects of smoking reduction by simulating an elimination of smoking among subgroups of smokers in South Korea, Singapore, and the United States. We found that life expectancy would increase by 0.2 to 1.5 years among light smokers and 2.5 to 3.7 years among heavy smokers. Whereas both interventions led to an increased life expectancy and decreased the prevalence of chronic diseases in all three countries, the life-extension benefits were greatest for those who would otherwise have been heavy smokers. Our findings illustrate how smoking interventions may have significant economic and social benefits, especially for life extension, that vary across countries.

Original languageEnglish
Pages (from-to)92-104
Number of pages13
JournalHealth Economics (United Kingdom)
Issue numberS1
StatePublished - Nov 2021

Bibliographical note

Publisher Copyright:
© 2019 The Authors. Health Economics published by John Wiley & Sons Ltd


  • Singapore
  • South Korea
  • United States
  • healthy aging
  • heavy smokers
  • microsimulation
  • smoking interventions
  • tobacco control


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