The costs of tobacco, alcohol and illicit drug abuse to Australian Society in 2004/05
9. Future research
Over the years in which we have been involved in this work, data availability and reliability have improved significantly. However, we still wish to draw attention to areas where there are either no data or inadequate data and where the production of sound information would enhance the usefulness of social cost studies for measurement and evaluation of policy effectiveness. Several of these ecommendations are carried forward from our previous report published in 2002, in areas where data availability has not improved significantly in the ensuing period.
9.1 Re-estimation of the results using the human capital approachIt has been argued above that the demographic approach adopted for this study is preferable to the more widely-adopted human capital approach. These two approaches are compared in Section 2 above. The present authors have suggested that the demographic approach produces results whose interpretation is more straightforward and more easily understood. Further, it permits incorporation into the results of any benefits (that is, negative costs) of drug abuse, which should from a public policy viewpoint also be taken into account. The argument in favour of adopting the human capital approach is that, since this is the approach adopted in most international studies, its adoption in the Australian study would facilitate comparison with such studies in other countries.
As pointed out in Section 2 above, the data sets used in the two approaches are largely overlapping and it would be feasible to extend the present study to produce human capital-based estimates. It should be emphasised that, in this case, the results of the new study should be very carefully explained and interpreted.
9.2 Recalculation of the 1998/99 alcohol cost estimatesAs indicated above, the 2004/05 estimates of the social costs of alcohol are not comparable with the earlier estimates for 1998/99, for two important reasons:
- The methodology for the estimation of the alcohol-attributable fractions has changed.
- Much improved estimates of the impact of alcohol consumption on workplace absenteeism have become available.
- the revised alcohol-attributable fractions
- the estimated reduction in the Australian population attributable to alcohol abuse
- the costs of alcohol-attributable workplace absenteeism.
It would be totally inappropriate to recalculate these 2004/05 results in line with the data used in the earlier study. There would be no justification for recalculating the latest estimates
using data now acknowledged to be incorrect.
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9.3 CrimeThere are several areas in which the availability of crime statistics could be improved if research resources were provided to the appropriate bodies.
The DUCO surveys provided very important information, but they were ‘one-offs’ and are now becoming dated. There is a case for their replication on a three-year cycle as these data cannot be obtained from administrative records, and criminal and drug use behaviours change. For example, recently there has been a decline in the use of heroin but a rise in methamphetamine. Similarly, there has been a decline in property crime but no decline in assaults. For cost estimates to reflect current costs, it is necessary to invest in the collection of longitudinal data in the criminal justice sector, comparable to the investment in research and data in the health sector.
The collection of DUMA should be expanded. It is currently not collected across all jurisdictions and existing DUMA data show substantial variation across states. As a result current estimates of attributable crime could be biased by the current selection of states. It is recommended that funding for DUMA as an ongoing monitoring program should be ensured.
There are no panel data on the general population that focus on onset, persistence and desistance from crime and drug use. The National Drug Strategy Household Survey does not appear to be the appropriate vehicle as it is already too long and the inclusion of criminal questions of the detail and specificity required would probably affect the survey response rate which is already down to 45 per cent.
Tobacco-attributable crime (including smuggling), and therefore its costs, remain unquantified.
9.4 Workplace absenteeism and reduced workplace productivity attributable to tobacco and illicit drugsRecent research at the National Centre for Education and Training on Addiction at Flinders University, based on data collected for the 2001 National Drug Strategy Household Survey, has provided the basis for improved estimates of workplace absenteeism attributable to the consumption of alcohol. Similar research in relation to absenteeism attributable to tobacco and to illicit drugs is recommended.
Once again, it has not been possible to identify research from which a reliable estimate of drug-attributable reductions in on-the-job productivity could be produced. These costs, currently unquantifiable, are likely to be considerable.
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9.5 The value of household workThe Australian Bureau of Statistics data on the value of unpaid work in the household have proved very useful but are now becoming dated. An updating of this research is recommended.
9.6 Smoking-attributable firesResearch conducted by the Queensland Fire and Rescue Service remains the only source of data for the quantification of the costs of smoking-attributable fires. Similar research by fire services in other states would permit assessment of whether the Queensland fire experience is typical of Australia as a whole.
9.7 EpidemiologyThe current research has demonstrated that estimates of the costs of alcohol and of illicit drugs could be significantly refined if further epidemiological research were conducted on:
- estimation of alcohol aetiological fractions by type of alcohol (beer, wine and spirits)
- estimation of illicit drug aetiological fractions by type of drug.
9.8 PharmaceuticalsThe present study includes an estimate of the costs of some pharmaceuticals prescribed for drug-attributable conditions, but this is a considerable underestimate of the total costs. It would be desirable to have comprehensive studies of prescribed and across-the-counter pharmaceuticals for drug-attributable conditions. Data on drug-attributable primary care provision also would enable more comprehensive estimates of health costs.
9.9 Prescribed pharmaceuticalsFurther, more extensive, research is necessary in order to be able to quantify the costs associated with abusive consumption of prescribed pharmaceuticals.
9.10 LitterAll three categories of drugs (alcohol, tobacco and illicit drugs) impose litter costs. However, adequate data on the basis of which it would be possible to estimate drug-attributable litter costs remain unavailable.
9.11 AmbulancesData collected by the Western Australian Department of Health and, in the case of drug overdoses, by the New South Wales Chief Health Officer provide the basis for the current estimates of drug-attributable ambulance costs. The collection by other states of ambulance data similar to the Western Australian data and the NSW drug overdose data would facilitate inter-state comparisons.
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9.12 Research and education expendituresWith the exception of research undertaken by Moore (2005) in relation to illicit drugs, there remains a lack of information on expenditures by the law enforcement, customs and education sectors on drug-related research and education.
9.13 Road accidentsThe Bureau of Transport and Regional Economics has produced three reports on road crash costs, the most recent being for the year 1996. This information is now becoming outdated and an updating would facilitate future studies of the costs of drug-attributable road accident costs.
9.14 Review of data needsIt was suggested by one of the reviewers of this report that, given the extensive data needs of research of this type and the data gaps which are acknowledged still to exist, an expert advisory meeting should be held to review future data needs. This would involve input from the various disciplines involved in this type of research. It would also involve advice from representatives of bodies using such research results and from those authorities who currently collect, collate and interpret existing data.
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