Reasons for the disagreements on the impact of smoking on medical care expenditures: a proposal for a uniform approach.

A recent paper suggested that smoking does not increase medical care expenditures and, therefore, that reduced smoking is unlikely to decrease it. This conclusion differs from that of most other studies in this area and the reasons for this disagreement are investigated. It is pointed out that medical care expenditure estimates yield different results depending on whether they are estimated on a per capita basis or in total for populations which change in size as smoking is reduced or eliminated. To avoid disagreement in future studies of this type, some specific proposals are made which should facilitate the comparison of results obtained from different studies.