New report shows crippling economic toll of smoking on California's fiscal health

By Maureen McInaney on January 14, 2003

Smoking costs in California are nearly $16 billion annually, or $ 3,331 per smoker every year, according to a report by the UCSF School of Nursing Institute for Health & Aging. The healthcare costs alone would equal one-quarter of the projected state deficit, according to Wendy Max, PhD, co-director of the Institute for Health & Aging and UCSF professor of health economics.

“Our study shows that even though tobacco control efforts in California are among the most successful in the nation, the cost of smoking in the state continues to increase,” said Max. “These numbers should be a wake-up call that we need to continue our efforts to reduce the health care costs, lives lost, and pain and suffering caused by smoking.”

On Tuesday, California’s Tobacco Education Research Oversight Committee (TEROC) will present recommendations that urge legislators to raise the tobacco tax to help alleviate the state’s financial crisis and increase support to tobacco control and education programs. TEROC’s call for a tobacco tax increase is one of the key recommendations contained in the Committee’s newly released Master Plan to the California Legislature. They propose that 20 cents per pack be earmarked for California’s Proposition 99-funded health education and research programs.

According to tobacco control experts in the state, every dollar invested in the California Tobacco Control Program saves the state at least $ 3 in direct health care costs and another $5 by reducing lost productivity.

The report also highlights the direct health care costs attributed to smoking, including hospital care, ambulatory care, nursing home expenses, prescription drug costs and home health care. All account for more than half of the burden at $8.6 billion. The researchers also state that lost productivity due to premature death amounts to a staggering $5.7 billion, with another $1.5 billion in lost productivity due to illness.


Other findings:

· Tobacco use is the number one cause of preventable disease and premature death killing 43,000 Californians each year and affecting millions of others nationwide with long-term health problems.

· While there are fewer smokers in California than there were a decade ago, 4.7 million Californians still smoke. Included are 4.5 million adults and 207,000 adolescents.

· More males than females smoke in California - 2.7 million or 22.1 percent of adult men and 1.9 million or 15.3 percent of adult women. Adolescent males smoke at similar rates to adolescent females - 7.7 percent vs. 7.4 percent.

· The cost of smoking for men is greater than that for women—$9.4 billion compared to $6.3 billion. Direct costs and indirect lost productivity costs due to illness are similar for men and women, while indirect costs of lost productivity from premature death are substantially greater for men.

· Expenditures for hospital care of current and former smokers amount to $4 billion, or 47 percent of total direct medical costs; ambulatory care services amount to $2.1 billion or 24 percent; nursing home care amounts to $1.3 billion or 15 percent; prescription drugs amount to $1.1 billion; and home health care amounts to $87 million.

Additional investigators on the report include: Dorothy Rice, ScD (Hon.), professor emerita UCSF Institute for Health & Aging; Hai-Yen Sung, PhD, research specialist in the UCSF Institute for Health & Aging; Xiulan Zhang, PhD, professor, Beijing Normal University;  and Leonard Miller, PhD, economist and professor in the School of Social Welfare at UC Berkeley.

The report was funded by the Tobacco Control Section of the California Department of Health Services.

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