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Cited by 175Smoking Behavior and CessationHealth Systems, Economic Evaluations, Quality of LifeGlobal Public Health Policies and Epidemiology

Medical costs of smoking in the United States: estimates, their validity, and their implications

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Warner, K. E, Hodgson, T. A, Carroll, C. E·1999·Tobacco Control
DOI 10.1136/tc.8.3.290PMC PMC1763946
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Abstract

OBJECTIVE: To compare estimates of the medical costs of smoking in the United States and to consider their relevance to assessing the costs of smoking in developing countries and the net economic burden of smoking. DATA SOURCES: A Medline search through early 1999 using keywords "smoking" and "cost", with review of article reference lists. STUDY SELECTION: Peer-reviewed papers examining medical costs in a single year, covering the non-institutionalised American population. DATA EXTRACTION: Methods underlying study estimates were identified, described, and compared with attributable expenditure methodology in the literature dealing with costs of illness. Differences in methods were associated with implied differences in findings. DATA SYNTHESIS: With one exception, the studies find the annual medical costs of smoking to constitute approximately 6-8% of American personal health expenditures. The exception, a recent study, found much larger attributable expenditures. The lower estimates may reflect the limitation of analysis to costs associated with the principal smoking-related diseases. The higher estimate derives from analysis of smoking-attributable differences in all medical costs. However, the finding from the most recent study, also considering all medical costs, fell in the 6-8% range. CONCLUSIONS: The medical costs of smoking in the United States equal, and may well exceed, the commonly referenced figure of 6-8%. This literature has direct methodological relevance to developing countries interested in assessing the magnitude of their current cost-of-smoking burden and their future burdens, with differences in tobacco use histories and the availability of chronic disease treatment affecting country-specific estimates. The debate over the use of gross or net medical cost estimates is likely to intensify with the proliferation of lawsuits against the tobacco industry to recover expenditures on tobacco-produced disease.

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  • A large proportion of healthcare expenditures, including costs to individuals, businesses, and society, is attributable to poor lifestyle behaviors, and these costs are lowered by initiatives that promote healthy lifestyles.

    “Ironically, a large proportion of healthcare expenditures, including costs to individuals, businesses, and society, is attributable to poor lifestyle behaviors, 114 -117 and these costs are lowered by initiatives that promote healthy lifestyles. 118”

    From Beyond Established and Novel Risk Factors: Lifestyle Risk Factors for Cardiovascular Disease (2008) · cites this paper as [115]

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Research works printed but not linked: 2

  1. Leu RE, Schaub T. Does smoking increase medical expenditures? Soc Sci Med 1983;17:1907-14.
  2. Bartlett JC, Miller LS, Rice DP, et al (US Centers for Disease Control and Prevention). Medical expenditures attributable to cigarette smoking-United States, 1993. MMWR 1994;43:469-72.

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Authors
Warner, K. E., Hodgson, T. A., & Carroll, C. E.
Affiliations
  • University of Michigan (US)
  • Centers for Disease Control and Prevention (US)
  • National Center for Health Statistics (US)
ORCID
Warner, K. E
Venue
Tobacco Control
Publisher
BMJ
Published
1999-09-01
Volume
8
Issue
3
Pages
290-300
ISSN
0964-4563 (ISSN-L)
DOI
10.1136/tc.8.3.290
PMC
PMC1763946
OpenAlex
W2043788256
Cited by
175
References
45
Citations by year
2026: 2 · 2025: 4 · 2024: 3 · 2023: 4 · 2022: 4 · 2021: 3 · 2020: 4 · 2019: 7 · 2018: 6 · 2017: 2 · 2016: 5 · 2015: 4 · 2014: 13 · 2013: 10 · 2012: 7
FWCI
3.22
Type
journal article
Language
en
Open access
Locations
  • Tobacco Control (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • HighWire Press Open Archive (submittedVersion)
Funders
  • Robert Wood Johnson Foundation
  • Centers for Disease Control and Prevention
Topics
  • Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
  • Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
  • Social Sciences › Business, Management and Accounting › Organizational Behavior and Human Resource Management › Global Public Health Policies and Epidemiology
Keywords
smoking-related diseases, economic burden, economic burden of smoking, developing countries, tobacco litigation, health care costs
MeSH terms
Developing Countries, Female, Health Status, Humans, Lung Neoplasms, Male, Peer Review, Plants, Toxic, Smoking, Nicotiana, United States, Reproducibility of Results, Health Care Costs

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