With the economic and societal costs of smoking totaling more than $300 billion per year, a report on The Real Cost of Smoking by State shows how states rank.
To encourage the estimated 34.2 million tobacco users in the U.S. to kick this dangerous habit, WalletHub calculated the potential monetary losses — including the lifetime and annual costs of a cigarette pack per day, health care expenditures, income losses, and other costs — brought on by smoking and exposure to secondhand smoke.
The Financial Cost of Smoking in California (1=Lowest, 25=Avg.):
- Out-of-Pocket Cost per Smoker – $155,928 (Rank: 39th)
- Financial-Opportunity Cost per Smoker – $1,631,258 (Rank: 39th)
- Health-Care Cost per Smoker – $234,261 (Rank: 44th)
- Income Loss per Smoker – $650,030 (Rank: 43rd)
- Other Costs per Smoker – $17,048 (Rank: 50th)
- Total Cost Over Lifetime per Smoker: $$2,688,526
- Total Cost per Year per Smoker: $56,011
What are the most effective strategies for individuals trying to quit smoking? What approaches typically fail?
“Most smokers want to quit, but it often takes multiple attempts before quitting is achieved, often up to 20 or more. But the good news is that there are now more ex-smokers than current smokers. The odds of quitting are increased if the smoker gets counseling combined with smoking cessation medications such as nicotine replacement therapy and varenicline. Calling a toll-free quit line (1-800-QUITNOW) is also helpful. Unassisted quitting (“cold turkey”) is less helpful, and living with someone who smokes is also a handicap,” said Steven A. Schroeder, MD, director, Smoking Cessation Leadership Center; Distinguished Professor, University of California, San Francisco.
“In general, about 5% of smokers will quit each year according to national surveys. To increase the rate of success, the USPHS Clinical Practice Guideline ‘Treating Tobacco Use and Dependence’ recommends a combination of cessation counseling and medication (nicotine replacement therapy or varenicline or bupropion). Strategies that use one without the other are less likely to result in a successful quit. The Clinical Practice Guideline also recommends that healthcare providers take an active role in helping smokers quit by ‘asking’ all patients if they use tobacco, ‘advising’ tobacco users to quit, and ‘referring’ tobacco users to treatment that includes counseling and medication. This is known as the Ask-Advise-Refer model,” according to Amy Ferketich, Ph.D., professor at Ohio State University.
Should e-cigarettes be regulated and taxed as cigarettes or as medical devices?
“E-cigarettes do not meet the definition of a medical device per Section 201(h) of the Food, Drug, and Cosmetic Act. E-cigarettes, however, as well as other vaping products meet the definition of a tobacco product and should be regulated and taxed as other tobacco products. There is a critical need for rigorous randomized controlled trials to establish e-cigarettes as effective cessation devices, relative to other FDA-approved therapies such as gum, lozenges, and patches,” added Mary Rezk-Hanna, Ph.D., FAHA, assistant professor at The University of California, Los Angeles.
“E-cigarettes are not going to be taxed and regulated as medical devices. This would require large clinical trials that cost lots of money and e-cigarette companies certainly are not motivated to do this. If e-cigarettes were only available through a prescription, this would likely create quite an illicit market…I think it is reasonable to regulate and tax e-cigarettes as a tobacco product, since so many people, especially young people, are using them for pleasure – not as a smoking cessation device. These regulations must be enforced,” said Holly R. Middlekauff, MD, a professor at The University of California, Los Angeles.
How can state and local authorities encourage people to quit smoking? Is there a role for employers? Health insurance companies?
“There are proven tobacco control measures: taxation, clean indoor air laws, counter-marketing, and smoking cessation support. Employers and health insurers can offer lower health insurance premiums for non-smokers, encourage smoke-free workplaces, offer bonuses for quitting, and cover smoking cessation therapies,” Schroeder added.
“States and local authorities should put resources into prevention programs for school-age students and cessation programs (e.g., tobacco quit lines, other community cessation programs) for those who use tobacco. Employers can also help by creating policies that prohibit tobacco use (including e-cigarettes) at work. Employers and insurers, too, should make it easy for smokers to access cessation medication and counseling,” Ferketich said.
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