Every year 6,000 people die in Wales as a result of smoking
New figures indicate that smoking is costing the NHS in Wales more than £7m every week.
A report commissioned by Ash Wales and British Heart Foundation Cymru reveals that smoking related diseases cost NHS Wales an estimated £386m in 2007/08.
Smoking accounts for around 22% of adult hospital admission costs, over £235m every year, the research said.
The assembly government said tackling smoking was a priority and attitudes were changing towards smoking.
The report, being presented at an international tobacco control conference in Cardiff by Prof Ceri J Phillips of Swansea University, said £43m was also spent on GP consultations.
It said that nearly a quarter of the adult population in Wales are smokers and most of these started smoking as children.
With 6,000 people in Wales dying each year as a result of smoking, the report said many more would continue to die each year, or suffer chronic long-term illnesses, if these levels were sustained.
Tanya Buchanan, of Ash Wales, said: "What this report doesn't include is the huge cost to the economy of Wales, for example more than £23m from lost productivity through smoking related sickness absences and £6m from smoking related fires.
THE REPORT'S MAIN FINDINGS
Smoking cost NHS Wales an estimated £386m in 2007/08; equivalent to £129 per head and 7% of total healthcare expenditure in Wales.
£235.6m spent on hospital admissions (22% of total)
£43.1m spent on GP consultations (13%)
£21.5m spent on outpatient attendances (6%)
£6.2m spent on practice nurse consultations (12%)
£79.3m spent on prescriptions (14%)
Source: Ash Wales and British Heart Foundation Cymru
"Not to mention the emotional cost of family members seeing their loved ones suffer daily from smoking related illnesses."
Ms Buchanan said that the report should not be used to demonise smokers but to prompt a move towards a more proactive health service, promoting and protecting people's health throughout their lives.
"We urge the Welsh Assembly Government to act now and implement a comprehensive, and fully funded, tobacco control strategy for Wales, in line with other parts of the UK," she said.
Delyth Lloyd, public affairs manager for British Heart Foundation Cymru, added: "The findings of this report should be of real concern to all who are involved in public health policy and decision making in Wales."
A Welsh Assembly Government spokesman said it had made tackling smoking a priority and there were encouraging signs that attitudes towards smoking in Wales were changing.
"Research we have commissioned shows that the smoking ban, introduced in April 2007, has had a significant impact on smoking habits, with people reporting that they're smoking less and thinking more about quitting," said the spokesman.
Schemes such as Smokebugs and Assist, which aim to prevent young people trying tobacco, were also starting to pay off, he said.
"The number of 15 to 16-year-old boys smoking has dropped from 21% in 1998 to 12% in 2006, while smoking among girls in that age group has fallen from 29% in 1998 to 23% in 2006."
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