Introduction. Despite hundreds of millions of dollars spent on randomized controlled trials and tobacco control interventions, to date the health and cost benefits of tobacco control interventions have been projected, rather than measured. So we used time-series analysis to assess possible mortality and cost effects of the major smoking reductions seen in California in the 1990s.
Methods. California and non-California US mortality data for 1958-97 was obtained from vital statistics, and age-adjusted to the 1990 US standard. Quarterly San Francisco and Los Angeles medical care inflation data for 1980-99 was obtained from the Bureau of Labor Statistics. Deviation from trends was assessed using CDC SSS1 software time-series analysis.
Results. As California's tobacco consumption fell far below US rates in the 1990s, California's survival advantage (mortality rate deficit versus the remaining US) increased to nearly 2 standard deviations above the historical average. This survival advantage was particularly marked for smoking-related diseases such as COPD, lung cancer, and injury and represents over 10,000 lives and $400 million in terminal care costs saved in 1997 alone. California's largest cities have also seen near concurrent deficits of medical care inflation of about 4% and 2 standard deviations from historical norms by 1999, representing possible savings of over $5 billion/year in 1999 if extrapolated statewide.
Comment. California's recent smoking deficits have been closely followed by large mortality and medical cost deficits, compared to the remaining US. California's tobacco control program likely has saved both lives and money.
Learning Objectives: Quantify trends in smoking, mortality, and medical care cost inflation in California Quantify associations between those trends
Keywords: Tobacco Policy, Mortality
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.