Deaths from secondhand smoke exposure at home among California's different racial/ethnic groups: Economic implications

Background. Secondhand smoke (SHS) exposure is associated with illness and death as well as lost productivity and economic costs. The goal of this study was to estimate the number of SHS-attributable deaths, years of potential life lost (YPLL), and the value of lost productivity by race/ethnicity for California in 2009. Methods. The number of SHS-attributable deaths among nonsmokers from three adult and four infant conditions was determined using an epidemiological approach. For each death, the YPLL and the value of lost productivity from earnings and household production were estimated. Results. SHS exposure resulted in the deaths of 821 Californians in 2009, including 794 adults and 27 infants. The greatest number of deaths resulted from ischemic heart disease (691), followed by lung cancer (90), and perinatal conditions (27). Deaths from SHS exposure resulted in a loss of over 13,000 YPLL, and $100 million of lost productivity. Blacks represent 6% of California's population, but accounted for 7% of deaths, 14% of YPLL, 21% of PVLE, and 29% of infant deaths attributable to SHS. Hispanics represent 39% of California's population, and accounted for 7% of deaths, 10% of YPLL, and 13% of PVLE. Conclusions. The economic toll resulting from SHS exposure is substantial and varies considerably among California's racial/ethnic groups. Interventions need to be designed that target vulnerable populations to reduce the health and economic burden of SHS. California has had many successes in protecting people from SHS in the workplace, but challenges remain in reducing exposure to SHS at home.