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Comparative Study
. 2003 Apr;38(2):733-49.
doi: 10.1111/1475-6773.00142.

Health care costs among smokers, former smokers, and never smokers in an HMO

Paul A Fishman  1 , Zeba M Khan, Ella E Thompson, Susan J Curry
Affiliations
Comparative Study

Health care costs among smokers, former smokers, and never smokers in an HMO

Paul A Fishman et al. Health Serv Res. 2003 Apr.

Abstract

Objective: We estimate long-term health care costs of former smokers compared with continuing and never smokers using a retrospective cohort study of HMO enrollees. Previous research on health care costs associated with former smokers has suggested that quitters may incur greater health care costs than continuing smokers, therefore, getting people to quit creates more expensive health care consumers. We studied the trend in cost for former smokers over seven years after they quit to assess how the cessation experience impacts total health care cost.

Data sources/study setting: Group Health Cooperative (GHC), a nonprofit mixed model health maintenance organization in western Washington state.

Study design: Retrospective cohort study using automated and primary data collected through telephone interviews.

Principal findings: We find that former smokers' costs are significantly greater (p<.05) in the year immediately following cessation relative to continuing smokers, but former smokers' costs fall in year two. This decrease maintains throughout the six-year follow-up period. Although former smokers cost more than continuing smokers in the year after cessation, this increase appears to be transient. Long-term costs for former smokers are not statistically different from those of continuing smokers and cumulative health care expenses are lower by the seventh year postquit. Our evidence suggests that smoking cessation does not increase long-term heath care costs.

Conclusions: Health care costs among former smokers increase relative to continuing smokers in the year after cessation but fall to a level that is statistically indistinguishable in the second year postquit. Any net increase in costs among former smokers relative to continuing smokers appears compensated for within two years post-quit and is maintained for at least six years after cessation.

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Figures

Figure 1
Figure 1
Follow-up Data Availability by Index Year and Smoking Status
Figure 2
Figure 2
Health Care Costs over Time by Smoking Status
Figure 3
Figure 3
Discounted Cumulative Cost Difference: Former versus Continuing Smokers
See this image and copyright information in PMC

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References

    1. Barendregt JJ, Bonneux L, van der Maas PJ. “The Health Care Costs of Smoking.”. New England Journal of Medicine. 1997;337(15):1052–7. - PubMed
    1. Bartecchi CE, MacKenzie TD, Schyle RV. “The Human Costs of Tobacco Use.”. New England Journal of Medicine. 1994;330(13):907–12. - PubMed
    1. Bartlett JC, Miller LS, Rice DP, Max WB. “Medical Care Expenditures Attributable to Cigarette Smoking—United States 1993.”. Morbidity and Mortality Weekly Report. 1994;43:469–72. - PubMed
    1. Blough DK, Madden CW, Hornbrook MC. “Modeling Risk Using Generalized Linear Models.”. Journal of Health Economics. 1999;18(2):153–71. - PubMed
    1. Brauer LH, Hatsukami D, Hanson K, Shiffman S. “Smoking Topography in Tobacco Chippers and Dependent Smokers.”. Addictive Behavior. 1996;21(2):233–8. - PubMed

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