Abstract

The aim of the study was to develop estimates of the economic impact of smoking in each of California’s 58 counties. Estimates are presented in 1993 dollars. Three measures of the economic impact of smoking were estimated. Direct cost represents the amount spent on hospital admissions, physician services, nursinghome care, medications, and other services used due to smoking- related illness. Morbidity cost is the value of lost productivity resulting from smoking-related loss of work days and days not spent in other productive activity. Mortality loss results from premature death due to smoking-related illness and represents the value of productivity loss. The methodology for estimating cost involved three steps. First the smoking attributable fraction (SAF), that is, the proportion of cases or deaths that results from smoking, was estimated for each region of California for each smoking related disease. Second, the SAF was applied to the number of deaths, days lost from work or productive activity (disability), or health care expenditures. Finally, smoking related deaths or disability were valued using the human capital approach. The total cost of smoking in California was estimated to be $10.0 billion, amounting to $314 per Californian and $2014 per smoker.