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 Using recent health and medical spending surveys, researchers
calculated that 8.7 percent of all healthcare spending, or $170
billion a year, is for illness caused by tobacco smoke, and public
programs like Medicare and Medicaid paid for most of these costs.
“Fifty years after the first Surgeon General’s report, tobacco use
remains the nation’s leading preventable cause of death and disease,
despite declines in adult cigarette smoking prevalence,” said Xin Xu
from the Centers for Disease Control and Prevention (CDC), who led
the study.
Over 18 percent of U.S. adults smoke cigarettes and about one in
five deaths are caused by smoking, according to the CDC.
Xu and colleagues linked data on healthcare use and costs from the
2006-2010 Medical Expenditure Panel Survey to the 2004-2009 National
Health Interview Survey for a nationally-representative picture of
smoking behavior and costs.
Out of more than 40,000 adults, 21.5 percent were current smokers,
22.6 percent were former smokers and 56 percent had never smoked.
The researchers used prior data on smoking-related disease and
deaths to calculate the proportion of healthcare spending by each
person that could be attributed to smoking.
They also adjusted their figures for factors like excess drinking,
obesity and socioeconomic status, and calculated the proportion of
spending by payer.
In that analysis, 9.6 percent of Medicare spending, 15.2 percent of
Medicaid spending and 32.8 percent of other government healthcare
spending by sources such as the Veterans Affairs department, Tricare
and the Indian Health Service, were attributable to smoking.
Of the $170 billion spent on smoking-related healthcare, more than
60 percent was paid by government sources, they wrote in the
American Journal of Preventive Medicine.
Smoking-related healthcare costs affect most types of medical care,
said Kenneth Warner at the University of Michigan School of Public
Health. “Smoking infiltrates the entire body, through the blood
stream, and causes disease in many of the body's organs,” he told
Reuters Health in an email.
Along with lung and heart problems, smoking can cause eye disease,
skin problems and many cancers including pancreatic and bladder
cancer, noted Warner, who was not involved in the new analysis.
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“This study shows that, in addition to the human misery it inflicts,
(smoking) imposes a substantial burden on the nation's health care
institutions, especially those funded by the public's tax dollars,”
he said.
The true cost of tobacco use may be even higher, Xu said. His study
didn't include medical costs linked to other tobacco products like
cigars and chewing tobacco.
In 1964, the Surgeon General gave the first report on smoking and
health. Since then, there have been many anti-tobacco efforts,
ranging from banning tobacco in workplaces to quit-smoking help
lines.
Mass media campaigns can be effective in reducing cigarette use, Xu
said. In particular, the CDC’s current “Tips from Former Smokers”
campaign is credited with an estimated 100,000 smokers quitting
permanently.
The combination of research, publicity, policy and treatment has
prevented eight million premature deaths in the U.S. since 1964,
according to a 2014 Surgeon General's report. Based on research
published this year by Warner and his colleagues, he said, “Almost a
third of the increase in adult life expectancy since 1964 is
attributable to tobacco control.”
“Smoking kills about 480,000 Americans each year and remains the
leading cause of preventable death and disease in the United States.
No matter what age, it is never too late to quit,” Xu said.
SOURCE: http://bit.ly/1sCvb0k American Journal of Preventive
Medicine, online December 9, 2014.
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