UCSF study finds African-Americans bear disproportionate burden of smoking costs in California

African Americans comprise six percent of the California adult population, yet they account for over eight percent of the state’s smoking-attributable health care expenditures and 13 percent of smoking-attributable mortality costs, according to a new analysis by UCSF researchers.

In order to provide an objective picture of the disproportionate economic burden of tobacco use for African American Californians, the UCSF team assessed data from 2002, including health care costs related to smoking and productivity losses from smoking-caused mortality. Study findings are published in the January 2010 issue of the “American Journal of Public Health.”

“California has one of the most comprehensive tobacco control programs in the world, and smoking prevalence in the state has been declining steadily as a result. However, not all Californians have benefited equally from these efforts,” said lead author Wendy Max, PhD, professor-in-residence of health economics and co-director of the UCSF Institute for Health & Aging, School of Nursing. “Hopefully these data can be used to strengthen tobacco control programs and smoking cessation efforts throughout African American communities.”

Researchers analyzed smoking-attributable costs for diseases, such as cancer and cardiovascular disease, for which incidence is identified in the 2004 US Surgeon General Report as causally related to cigarette smoking.  They focused on expenditures for ambulatory care, prescription drugs, inpatient care, and home health care. The team also assessed smoking-attributable mortality for Californians aged 35 years and older using three measures: deaths, years of potential life lost, and productivity losses.

Findings include:

• African Americans lose more years (16.3) of life per death than other Californians (12.5 years) due to smoking-attributable causes.  A total of 3013 African American Californians died of smoking-attributable illness in 2002, representing a loss of over 49,000 years of life and $784 million in productivity.

• Adult smoking prevalence in 2002 for African Americans was 19.3 percent compared with 15.4 percent for all Californians.

• The total cost of smoking for the African American community amounted to $1.4 billion in 2002, or $1.8 billion in 2008 dollars.

“It is clear that we need to tailor more tobacco control programs to African Americans in California,” said Max. “In addition, there exists a long history of tobacco industry promotions and economic support targeted to certain ethnic groups, particularly African Americans and Hispanics. I would encourage these communities to carefully consider the benefits of such programs in light of the tremendous economic and human costs.”

The study included a national advisory panel of members of African American and Hispanic community organizations. Panelists advised the study team on the application of research models and are helping disseminate findings throughout California communities.

Co-authors are Hai-Yen Sung, PhD; Lue-Yen Tucker, BA; and Brad Stark, BA; all with the UCSF Institute for Health & Aging, School of Nursing at the time of the study. The research was supported by funds from the Tobacco-Related Disease Research Program of the University of California.

UCSF is a leading university dedicated to promoting health worldwide through advanced biomedical research, graduate-level education in the life sciences and health professions, and excellence in patient care.

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