Abstract
BackgroundLarge state tobacco control programs have been shown to reduce smoking and would be expected to affect health care costs. We investigate the effect of California's large-scale tobacco control program on aggregate personal health care expenditures in the state.Methods and FindingsCointegrating regressions were used to predict (1) the difference in per capita cigarette consumption between California and 38 control states as a function of the difference in cumulative expenditures of the California and control state tobacco control programs, and (2) the relationship between the difference in cigarette consumption and the difference in per capita personal health expenditures between the control states and California between 1980 and 2004. Between 1989 (when it started) and 2004, the California program was associated with $86 billion (2004 US dollars) (95% confidence interval [CI] $28 billion to $151 billion) lower health care expenditures than would have been expected without the program. This reduction grew over time, reaching 7.3% (95% CI 2.7%–12.1%) of total health care expenditures in 2004.ConclusionsA strong tobacco control program is not only associated with reduced smoking, but also with reductions in health care expenditures.
Highlights
Large-scale tobacco control programs reduce cigarette consumption [1,2] and tobacco-induced heart disease [3] and cancer [4,5,6]
An increase of one pack per capita per annum consumption of cigarettes is estimated to increase per capita health care costs by $27.00 (SE $1.82). Both average California and control cigarette prices have a significant effect on the difference in cigarette consumption
The observed and predicted personal health care expenditures and difference in cigarette consumption between the control states and California with and without tobacco control expenditures show that the program had a substantial effect on both variables
Summary
Large-scale tobacco control programs reduce cigarette consumption [1,2] and tobacco-induced heart disease [3] and cancer [4,5,6]. Increased state and United States health care expenditures have been linked with smoking [9,10,11], and would be expected to diminish with reduced smoking, but there has been no direct estimate of the effects of large-scale tobacco control programs on health care expenditures. The program has been functioning continuously at varying levels of intensity since which permitted us to investigate the effect of California’s large-scale state tobacco control program on aggregate personal health care expenditures in the state. We investigate the effect of California’s large-scale tobacco control program on aggregate personal health care expenditures in the state. It is estimated that by 2030, annual deaths from tobacco use will be 8 million worldwide Eighty percent of these deaths will occur in the developing world. An estimated 200,000 workers die annually from exposure to smoke at work, according to the International Labour Organization
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