Does smoking increase medical care expenditure?

doi:10.1016/0277-9536(83)90168-5

Social Science & Medicine

Volume 17, Issue 23, 1983, Pages 1907-1914

https://doi.org/10.1016/0277-9536(83)90168-5 Get rights and content

Abstract

The impact of smoking on medical care expenditure is analyzed, challenging the widespread belief that smoking imposes a large cost burden on health services systems. The results imply that lifetime expenditure is higher for nonsmokers than for smokers because smokers' higher annual utilization rates are overcompensated for by nonsmokers' higher life expectancy. Population simulation, taking into account the effects of past smoking on present population size and composition, suggests that 1976 expenditure would have been the same if no male born since 1876 had ever smoked. The male population would have been larger, particularly at older ages, increasing medical care expenditure, but this increase would have been offset by lower annual medical care utilization rates. Thus the results imply that smoking does not increase medical care expenditure and, therefore, reducing smoking is unlikely to decrease it.

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Citation Excerpt :
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This article is part of a supplement entitled Advancing Smoking Cessation in California's Medicaid Population, which is sponsored by the California Department of Public Health.
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It is controversial whether smokers have higher lifetime medical expenditures than non-smokers, because smokers have high annual medical expenditures but comparatively short lives. We examined differences in lifetime medical expenditures between them.
We constructed life tables for male smokers and non-smokers from 40 years of age. We calculated average annual medical expenditures of them categorized by survivors and deceased, which were used to examine differences in lifetime medical expenditures between them and perform sensitivity analyses.
Smokers had a higher mortality rate, shorter life expectancy, and generally higher annual medical expenditures than non-smokers. We also observed tendencies for smokers to have higher inpatient expenditures, but non-smokers to have higher outpatient expenditures. Although non-smokers had lower long-term cumulative medical expenditures between 64 and 81 years of age, their lifetime medical expenditures were higher by a minimal amount. Sensitivity analyses did not change this result.
Smoking may not cause increases in lifetime medical expenditures because smokers had lower lifetime medical expenditures than non-smokers. However, it was clear that smokers, especially survivors, often had higher annual medical expenditures than non-smokers. The importance of tobacco control is still relevant.
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Aggressively Regressive: The 'Sin Taxes' that Make the Poor Poorer
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^☆: A preliminary version was presented at the “Health Economics Study Group Meeting”, January 6–8, 1982, in Glasgow.

^∗: The authors would like to thank Theodor Abelin, René L. Frey, Felix Gutzwiller, Gavin Mooney, and Burton Weisbrod for helpful comments.

View full text

Does smoking increase medical care expenditure?☆

Abstract

J. chron. Dis.

Lancet

Smoking and alcohol abuse: a comparison of their economic consequences

New Engl. J. Med.

Smoking and Health

The relationship of smoking and some social covariables to mortality and lung cancer morbidity

The Causes and Effects of Smoking

Smoking and Health Now

Smoking Or Health

Mortality in relation to smoking: 20 years' observations on British doctors

Br. med. J.

Smoking and Health. Cancer. A Report of the Surgeon General

Smoking and its effects on health

WHO Technical Report Series No. 568

The effect of joint exposure to alcohol and tobacco on risk of cancer of the mouth and pharynx

J. chron. Dis.

Association of cancer sites with tobacco and alcohol consumption and socio-economic status of patients: interview study from the Third National Cancer Survey

J. natn. Cancer Inst.

Inanspruchnahme medizinischer Leistungen

Soz. Präv. med.