Tobacco control programs can reduce smoking, and when successful, they reduce personal health care costs, according to a study released on August 25, 2008 in the open-access journal PLoS Medicine.

The study specifically tracks the California Tobacco Control Program, which was established in 1989 with the goal of changing social norms surrounding tobacco use. Rather than focusing on adolescents, the program targeted adult users, with the idea that change in young people can be enabled by changes in the actions of their role models.

Though much has been postulated regarding the potential economic effects of large-scale tobacco programs, Stanton Glantz and colleagues at the University of California San Francisco hoped to perform an analysis to ascertain the actual relationship. In their analysis, they noted that the factors involved in health care expenditures may fluctuate for many reasons that are not related to patient habits, such as changes in medical technology or demographic shifts. They used regression analysis to minimize many of these effects to determine the effects of the tobacco control program alone on health care expenditures.

In California, 3.6 billion fewer packs of cigarettes were sold during the 5 year course of the program. The tobacco industry did not gain an estimated $9.2 billion U.S. in pre-tax cigarette sales as a result of this.

Data in California was compared to a set of controls, the latter with either no comprehensive tobacco control program before 2000 or cigarette tax increases of $0.50 or more per pack over the period of the study. Between 1989, when the program started, and 2004, there was a savings of $86 billion U.S. in personal health care expenditure. These savings in cost grew, peaking at 7.3% in 2003-2004. Altogether, this represents a 50-fold return on the $1.8 billion U.S. that were invested in the program over this period.

The researchers point out that these economic indicators are of significance, especially when comparing the money invested in tobacco control programs with the large settlements and tobacco taxes collected. In this study lies the first evidence that tobacco control programs actually reduce health care costs — this only further justifies the implementation of such programs.

According to a report of the Global Tobacco Epidemic in 2008 by the W.H.O., all key tobacco control measures have not been implemented in any given country. It additionally states that around the world, the money collected in tobacco taxes each year is nearly 500 times the money spent on tobacco control measures.

Effect of the California Tobacco Control Program on personal health care expenditures.
Lightwood JM, Dinno A, Glantz SA
PLoS Med 5(8): e178.
doi:10.1371/journal.pmed.0050178
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Written by Anna Sophia McKenney