New America Media
By Julian Do and Peter Schurmann
LOS ANGELES â€“ We all know the health risks associated with smoking. But according to a new study from the University of California San Francisco (UCSF), the financial toll for states and counties is almost as staggering.
According to the UCSF School of Nursingâ€™s Institute for Health & Aging, smoking-related illnesses cost California $18.1 billion in 2009. That comes to about $487 per resident or $4,603 per smoker. The costs included direct healthcare expenses as well as lost productivity due to illness or death.
There were 34,363 smoking-related deaths in California for that year, 17 times the number of deaths related to AIDS, and five times the number of deaths from diabetes, influenza and pneumonia. The leading cause of smoking-related death was cancer, followed by cardiovascular disease, respiratory diseases, and pediatric disease. Secondhand smoke exposure caused 794 adult deaths.
Researchers also concluded that smokers are more likely to develop chronic lower respiratory disease (COPD), which kills one-in-seven Californians.
â€œThe good news is smoking used to cause one in five deaths,â€ said Wendy Max, professor of health economics at UCSF and one of the lead researchers for the study. â€œBut one in seven is still too high.â€
Max spoke at a briefing in October to release the findings of the study, which was supported by the Tobacco-Related Disease Research Program of the University of Californiaâ€™s Office of the President (UCOP).
About four million Californians still smoke on a daily basis. Among them, adult and adolescent males outnumbered female smokers, the study found, with smoking-related costs for men and boys amounting to $11.7 billion, compared to $6.4 billion for females.
Another troubling finding is the toll on families. Researchers found that relatives and others who live with smokers accounted for 54.4 percent â€“ or $9.8 billion â€“ of the total statewide cost, explained co-researcher Hai-Yen Sung, who also teaches health economics at UCSF. Sung noted that for employers, smoking-related losses amounted to $8.2 billion in lost productivity.
The study is the third in a series, the first two having been done in 1989 and again in 1999. It was released the same day as a government study that found some 14 million illnesses attributed to smoking nationally.
That study also found smoking rates to be highest among Asian Americans and African Americans, with rates in fact climbing for the latter.
Tracy Richmond McKnight is a program officer with the UCOP Tobacco Related Disease Research Program. She says the UCSF study was prompted by the â€œneed to know what the actual economic impact of smoking is on the state of California so as to better monitor whether tobacco control efforts are working or not.â€
She adds that another unique feature of the study is that it looks at both statewide costs as well as at a county-by-county level, allowing â€œlocal public health agencies to be able to assess how well their efforts are working within their local counties.â€
Paul Simon heads the office of Chronic Disease and Injury Prevention at the Los Angeles County Department of Public Health. Speaking at the UCLA briefing, he pointed out that smoking rates are higher in immigrant and low-income communities, but that â€œwithout additional resources, our capability to help communities of color reduce the number of smokers is greatly constrained.â€
Simon also pointed to a decline in resources needed for monitoring and enforcing smoking restrictions, which to date have been credited with helping to lower the overall number of smokers in the state.
According to Michael Ong, chair of the California Tobacco Education and Research Oversight Committee, such complacency has allowed tobacco manufacturers to ante up massive campaigns to attract new smokers and to promote e-cigarettes, which have become popular among younger smokers.
The UCSF study did not include data from e-cigarettes.
â€œWeâ€™re only now in the process of studying the health impacts of e-cigarettes but these products are already out there on the streets,â€ he said, adding that without additional resources, it would be hard for the state to continue enforcing existing restrictions while also tackling the challenges associated with e-cigarette products.
McKnight points out that while revenues derived from the sale of tobacco products helps fund prevention efforts, no such revenue comes from the sale of e-cigarettes. â€œAll the money the state generates for prevention programs, for cessation programs, for educating youth in the schools and for research â€“ none of these get revenue from e-cigarette sales,â€ she says. â€œTheyâ€™re not considered tobacco products.â€