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Cited by 116Smoking Behavior and CessationHealth Systems, Economic Evaluations, Quality of LifeEconomic and Financial Impacts of Cancer

The Financial Impact of Smoking on Health-Related Costs: A Review of the Literature

Max, Wendy·2001·American Journal of Health Promotion
DOI 10.4278/0890-1171-15.5.321
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Abstract

Purpose.: To summarize our knowledge of the economic impact of smoking on health-related outcomes and to discuss the quality of this evidence. The potential effect of smoking-related health promotion programs on reducing costs is discussed. Data Sources.: Studies reviewed were cited in recently published reviews, identified through database searches of MEDLINE/HealthSTAR, PsychINFO, and ABI/Inform or obtained from reference lists of other studies. Study Inclusion and Exclusion Criteria.: Included are studies of the health care and other costs of smoking published in English in peer-reviewed journals during the last 20 years. Studies of annual and lifetime costs are included as are studies of employer costs. Forty-nine studies were reviewed. Data Extraction Methods.: Data extracted were total costs, medical care and other direct costs, lost productivity, and mortality costs. Underlying methodologies were described and compared. Data Synthesis.: The annual cost of smoking is between 6 and 14% of personal health expenditures. Estimates have increased over time, reflecting better and more comprehensive methodologies. Smoking appears to result in increased lifetime costs, although some studies have found contrary results. In the workplace, smokers incur greater medical costs and more lost productivity than nonsmokers. They also impose costs on their nonsmoking coworkers. Major Conclusions.: The overwhelming body of evidence in the literature asserts that smoking imposes costs on an annual basis, that it leads to increased medical costs over the life span, and that many of these costs are borne by employers. Although the methods for studying this issue have evolved over time and are presently quite comprehensive, future research is needed to further substantiate the findings and develop further refinements.

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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 [116]

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Authors
Max, W.
Affiliations
University of California, San Francisco (US)
Corresponding author
Max, Wendy
ORCID
Max, Wendy
Venue
American Journal of Health Promotion
Publisher
SAGE Publications
Published
2001-05
Volume
15
Issue
5
Pages
321-331
ISSN
  • 0890-1171 (ISSN-L)
  • 2168-6602
DOI
10.4278/0890-1171-15.5.321
OpenAlex
W2063068484
Cited by
115
References
51
Citations by year
2026: 3 · 2025: 1 · 2024: 2 · 2023: 3 · 2022: 3 · 2021: 2 · 2020: 8 · 2019: 3 · 2018: 2 · 2017: 2 · 2016: 5 · 2015: 3 · 2014: 6 · 2013: 6 · 2012: 4
FWCI
4.15
Type
journal article
Language
en
Open access
closed
Licence
journals.sagepub.com/page/policies/text-and-data-mining-license (tdm)
Locations
  • American Journal of Health Promotion (publishedVersion)
  • PubMed (publishedVersion)
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 › Economics, Econometrics and Finance › Economics and Econometrics › Economic and Financial Impacts of Cancer
Keywords
smoking, economic burden of smoking, health care costs, productivity loss, employer costs, lifetime costs, mortality costs, cost estimation methods
MeSH terms
Absenteeism, Cost-Benefit Analysis, Cost Control, Health Promotion, Health Services Research, Humans, Smoking, United States, Health Care Costs, Employer Health Costs, Workplace, Cost of Illness

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