Smoking's economic cost to Taiwan is not limited to medical spending. A new study by the College of Public Health at Taipei Medical University found that smoking causes about US$4.6 billion, or more than NT$130 billion, in productivity losses each year. The amount equals about 0.6% of gross domestic product, exceeds 15% of annual National Health Insurance spending, and is higher than tobacco tax and tobacco health and welfare surcharge revenue.

The estimate drew attention because it includes not only medical costs, but also premature death, shorter working lives and reduced income. The team led by Associate Professor Lo Wei-cheng of the Department of Public Health at Taipei Medical University analyzed long-term data from more than 210,000 adults in Taiwan, combined with health insurance, death registration and labor income data. The study was published in 2026 in the international public health journal Public Health.

The study found that smoking affects both life expectancy and working years. Male smokers live about 2 years less than those who never smoked, while female smokers live about 1.4 years less. In income terms, each smoker loses about US$45,000 to US$61,000 over a lifetime, or about NT$1.35 million to NT$1.85 million.

Taiwan's adult smoking rate is now about 12% to 13%, and close to 20% among men, with the decline stalling in recent years. As e-cigarettes and heated tobacco products increase, tobacco control faces new challenges. The team estimated that if the smoking rate were cut in half, Taiwan could reduce years of life lost from premature death and lower long-term productivity losses.