Smoking Cessation Saves Money

Today’s Managing Health Care Costs Indicator is $14.7 million

Massachusetts just announced that researchers at George Washington University have completed an evaluation of the state’s smoking cessation program –and found it offered a 3:1 return on investment.

Here’s a link to the peer-reviewed journal article.   

This study uses previously reported decreases in rates of cardiovascular hospitalizations among participants, and then monetizes these. The decreases are jaw dropping:

-        46% for acute heart attack

-        49% for heart disease

-        32% for nonspecific chest pain

Program cost was about $183 per participant (for drugs and counseling), while decreased hospitalizations were valued at $571.

The strength of this analysis is only moderate. The weakness of this design is that those who were motivated to use the program were more likely to have lower costs than the general Medicaid population anyway. I would have liked to see the original study show total cardiovascular diease totals, to help insure that this finding does not represent selection bias.  Still – there were likely to be other health claims cost benefits which are not counted in this analysis.

Most states have used little or none of their tobacco settlement money to encourage smoking cessation. Massachusetts has gained real benefit by continuing to fund smoking cessation. States which are cutting smoking cessation programs due to their budget shortfalls can look forward to higher medical claims costs.

The Cost of Smoking

Today’s Managing Health Care Costs Indicator is $40

Click Image to Enlarge.  Source

I’m taking a break from this month’s Health Affairs today to highlight some posts from The Incidental Economist blog – which has grown to be among my favorites.

Don Taylor, author of “The Price of Smoking” reprises his calculations for the real cost of smoking per pack.

These are

• $33.00 – the cost of lost life years, lost wages and disability due to smoking  
• $5.50 – the cost borne by the family – mostly through increased spouse mortality
• $1.50 – the external cost, which includes increased health care costs (a mere $0.48), nonsmoker subsidy of smoker life insurance ($1.78), lost Social Security contributions ($1.02) and productivity losses ($1.00).   You might notice that this sum is equal to far more than a buck and a half – that’s because smokers ‘save’ the system money through lower pension and Social Security payouts and through taxes they pay for cigarettes. 

Here’s a link to the post.  

Smoking is the most important remediable cause of lost life years – and we should use all the arrows in our social policy quiver to get people to quit smoking.   That includes powerful choice architecture decisions to make smoking inconvenient, and higher taxes to discourage price-sensitive teens from getting hooked.   But the US has among the lowest smoking rates of developed countries, but the highest health care costs.  

Click image to enlarge.  Source 

By Taylor’s calculation, elimination of smoking alone would not solve our health care cost crisis.