Objective. To assess lifetime smoking-attributable (SA) healthcare costs, including largely nonfatal disease (debility) costs.
Design. Literature review to locate debilities a) very likely or b) prospectively from smoking, based on good or fair evidence of causation, respectively. Mathematical modeling summing debility and published Dutch fatal disease lifetime health care costs of smoking. Debility costs were computed from the SA% of each debility based on published relative risks and Dutch smoking prevalences, times that debility's fraction of a) published lifetime Dutch health care costs; or b) published national health care costs.
Main outcome measures. Estimated national health care cost % change from baseline 1) by years since cessation of smoking, and 2) averaged over 50 years, at 0, 3, 5, and 10% discount rates.
Results. Complete prevention or cessation of smoking very likely will reduce average annual national health costs by 1%, 1.5%, and 1.8% at 3%, 5%, or 10% discount rates, respectively. These cost reductions are likely underestimates, if smoking causes any of the major debilities repeatedly prospectively associated with smoking. Net cost reductions persist at those discount rates, even if smoking-related risks are less than half of the baseline estimate. These costs equate to a lifetime health care expense of over $0.30-0.60/pack of cigarettes sold in the US in 1995.
Conclusions Health care for debilities from smoking is expensive. Smoking likely increases overall lifetime health care costs.
Learning Objectives: Identify debilities likely due to smoking. Identify health care costs likely due to smoking. Identify the time course of cost savings from smoking cessation
Keywords: Cost Issues, Tobacco
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.
The 128th Annual Meeting of APHA