Today Nicotine & Tobacco Research publishes the third in a series of studies on the cost of smoking in California, one of the first US states to implement a comprehensive tobacco control program. Researchers estimated expenditures for smoking-attributable costs (healthcare, lost productivity from illness, and lost productivity from premature mortality) for the year 2009. The total cost came to $18.1 billion, amounting to $487 per California resident and $4,603 per smoker.
In two previous studies, conducted in 1989 and 1999, the annual financial impact of smoking on California's economy was tallied at $7.6 billion and $15.8 billion, respectively. Nominally, the figures show a 15% increase in the last decade, but inflation-adjusted totals show a very different picture: the total cost of smoking in 1999 expressed in 2009 constant dollars was $20.8 billion. Real costs have actually decreased by over 13%.
Many recent changes in smoking behavior are thought to have contributed to this decline. Adult smoking prevalence in California has fallen from 21.6% of adults in 1989, to 18.7% in 1999, to 13.6% in 2009. In 2010, that number fell again with just 11.9% of the state's adults smoking. Additionally, among those who continue to smoke, there has been a downward trend in smoking intensity - more smokers fell into the category of "nondaily" smokers, and both nondaily and daily smokers reported smoking fewer cigarettes per day, on average. Population shifts in the state, including a greater proportion of Hispanic and Asian Californians, are also worth noting, as these two population groups both have relatively low smoking prevalence.
While an $18.1 billion cost of smoking is still quite an economic burden for California to bear, the results of this study show that, overall, the state's tobacco control efforts have yielded positive results. "The California tobacco control program has been very effective," says Dr. Wendy Max, the study's lead author, "but there remains work to be done, especially in light of the changing landscape of tobacco products."
Correspondence should be directed to:
Wendy Max, Ph. D.
Institute for Health & Aging, School of Nursing
University of California, San Francisco
3333 California Street, Suite 340
San Francisco, CA 94118