J M Lightwood1, S A Glantz. 1. Institute for Health Policy Studies, Department of Medicine, University of California, San Francisco 94143-0124, USA.
Abstract
BACKGROUND: Most analyses of the economic benefits of smoking cessation consider long-term effects, which are often not of interest to public and private policy makers. These analyses fail to account for the time course of the short-run cost savings from the rapid decline in risk of acute myocardial infarction (AMI) and stroke. METHODS AND RESULTS: We estimate the time course of the fall in risk of AMI and stroke after smoking cessation and simulate the impact of a 1% absolute reduction in smoking prevalence on the number of and short-term direct medical costs associated with the prevented AMIs and strokes. In the first year, there would be 924+/-679 (mean+/-SD) fewer hospitalizations for AMI and 538+/-508 for stroke, resulting in an immediate savings of $44+/-26 million. A 7-year program that reduced smoking prevalence by 1% per year would result in a total of 63,840+/-15,521 fewer hospitalizations for AMI and 34,261+/-9133 fewer for stroke, resulting in a total savings of $3.20+/-0.59 billion in costs, and would prevent approximately 13,100 deaths resulting from AMI that occur before people reach the hospital. Creating a new nonsmoker reduces anticipated medical costs associated with AMI and stroke by $47 in the first year and by $853 during the next 7 years (discounting 2.5% per year). CONCLUSIONS: Although primary prevention of smoking among teenagers is important, reducing adult smoking pays more immediate dividends, both in terms of health improvements and cost savings.
BACKGROUND: Most analyses of the economic benefits of smoking cessation consider long-term effects, which are often not of interest to public and private policy makers. These analyses fail to account for the time course of the short-run cost savings from the rapid decline in risk of acute myocardial infarction (AMI) and stroke. METHODS AND RESULTS: We estimate the time course of the fall in risk of AMI and stroke after smoking cessation and simulate the impact of a 1% absolute reduction in smoking prevalence on the number of and short-term direct medical costs associated with the prevented AMIs and strokes. In the first year, there would be 924+/-679 (mean+/-SD) fewer hospitalizations for AMI and 538+/-508 for stroke, resulting in an immediate savings of $44+/-26 million. A 7-year program that reduced smoking prevalence by 1% per year would result in a total of 63,840+/-15,521 fewer hospitalizations for AMI and 34,261+/-9133 fewer for stroke, resulting in a total savings of $3.20+/-0.59 billion in costs, and would prevent approximately 13,100 deaths resulting from AMI that occur before people reach the hospital. Creating a new nonsmoker reduces anticipated medical costs associated with AMI and stroke by $47 in the first year and by $853 during the next 7 years (discounting 2.5% per year). CONCLUSIONS: Although primary prevention of smoking among teenagers is important, reducing adult smoking pays more immediate dividends, both in terms of health improvements and cost savings.
Authors: Joel F Wallace; Scott R Weingarten; Chiun-Fang Chiou; James M Henning; Andriana A Hohlbauch; Margaret S Richards; Nicole S Herzog; Lior S Lewensztain; Joshua J Ofman Journal: J Gen Intern Med Date: 2002-03 Impact factor: 5.128
Authors: Jill M Williams; Mia Hanos Zimmermann; Marc L Steinberg; Kunal K Gandhi; Cris Delnevo; Michael B Steinberg; Jonathan Foulds Journal: Adm Policy Ment Health Date: 2011-09