Hai-Yen Sung, PhD1, Wendy Max, PhD1, Lue-Yen Tucker1, Nancy Gordon, ScD2, Thomas Ray2, and Dorothy Rice, ScD1. (1) Institute for Health & Aging, University of California, San Francisco, 3333 California Street, Suite 340, San Francisco, CA 94118, 415 502-4697, firstname.lastname@example.org, (2) Kaiser Permanente Division of Research, 2000 Boradway, Oakland, CA 94612
The objective of this study is to examine the relationship of smoking cessation to medical care utilization and costs among members of a large HMO in Northern California. The study cohort comprises 46,902 respondents aged 20-84 from a stratified random sample of enrolled members who completed a Member Health Survey in 1996, 1999, and 2002. Utilization and costs of inpatient hospitalizations, ER visits, ambulatory care visits, and prescribed medications incurred within one year after the survey for all respondents were abstracted from the automated databases. Among the 43,911 respondents who maintained continuous 12-month membership after the survey, 25,940 were never smokers, 4,808 were current smokers, 866 were recent quitters within one year, 1,462 were former smokers who quit in the last 1-5 years, and 10,835 were former smokers who quit more than five years ago. The mean annual total cost among the 43,911 respondents was $3,687 (median, $1,341) in 2002 dollars. Using Tobit regression models which control for gender, age, and race/ethnicity, we found that former smokers' total costs were significantly greater (p<0.05) in the year following cessation compared to never smokers by $1,961 and current smokers by $1,340, but the excess costs diminished over time after quitting. The medical costs for long-term quitters after 5 years were not statistically different from those of current smokers. Our evidence suggests that health costs among former smokers increase in the year immediately following cessation relative to current smokers but fall to a level that is statistically indistinguishable after five years postquit.
Keywords: Smoking Cessation, Healthcare Costs
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The 134th Annual Meeting & Exposition (November 4-8, 2006) of APHA