Billions of Smoking Health Care Costs Paid By Taxpayers Interview with:
Darryl Konter

Health Communications Specialist
McNeal Professional Services
Centers for Disease Control and Prevention
Office on Smoking and Health Atlanta, GA 30341

Medical Research: What is the background for this study? What are the main findings?

Darryl Konter:

        Fifty years after the first Surgeon General’s report, tobacco use remains the nation’s leading preventable cause of death and disease, despite declines in adult cigarette smoking prevalence. Smoking-attributable healthcare spending is an important part of overall smoking attributable costs in the U.S.

        Data came from the 2006–2010 Medical Expenditure Panel Survey (MEPS) linked to the 2004–2009 National Health Interview Survey (NHIS). The MEPS is a nationally representative survey of civilian non-institutionalized families and individuals, their medical providers, and employers that collects information on individual healthcare utilization and medical expenditures.

        By 2010, 8.7% of annual healthcare spending in the U.S. could be attributed to cigarette smoking, amounting to as much as $170 billion per year.  More than 60% of the attributable spending was paid by public programs, including Medicare, other federally-sponsored programs, or Medicaid.

Medical Research: What should clinicians and patients take away from your report?

Darryl Konter:

         The United States Preventive Services Task Force recommended brief tobacco cessation intervention may reduce the burden of cigarette smoking. Clinicians advising their patients to quit smoking can increase the odds of a smoker successfully quitting.

        These findings indicate that comprehensive tobacco control programs and policies are still needed to continue progress toward ending the tobacco epidemic in the U.S. 50 years after the release of the first Surgeon General’s report on smoking and health.

        These population-based interventions and/or emerging “end game” strategies—including increases in tobacco product prices, comprehensive smoke-free laws, mass media anti-tobacco campaigns, state comprehensive tobacco control programs, a new generation of warning labels, or gradual reduction of cigarette nicotine content to non-addicting levels— can reduce cigarette consumption, prevent smoking initiation, and increase rates of successful quitting.

Medical Research: What recommendations do you have for future research as a result of this study?

Darryl Konter: 

         To better inform states and facilitate state comprehensive tobacco control programs, a further analysis to assess state specific cigarette smoking attributable health care spending is needed.

        More importantly, continuing research efforts to demonstrate the value and promote the use of these evidence-based public health interventions are needed to reduce the health care utilization aimed at smoking-related diseases and thereby, shrink smoking-attributable health care spending.


Cost-Effectiveness Analysis of the First Federally Funded Antismoking Campaign
Xin Xu, Robert L. Alexander, Sean A. Simpson, Scott Goates, James M. Nonnemaker, Kevin C. Davis, Tim McAfee
Publication stage: In Press Corrected Proof
Published online: December 9, 2014

Last Updated on December 14, 2014 by Marie Benz MD FAAD