Annals of Health Law
STRATEGY AGAINST SMOKING
four times, and increase the risk of developing lung cancer20 in men by
twenty-three times. As of 2010, 19.3% of all adults in the United States,
equal to 45. 3 million people continue to smoke. 21
In addition to the health impairments, tobacco use has serious economic
implications. 22 The annual health care expenditures caused by smoking are
abundant. In the period from 2000 to 2004, the Center for Disease Control
(CDC) estimated the average total public and private payments are
estimated to have been $96 billion per year. 23 Federal and state government
costs for Medicaid supposedly amount to approximately $30.9 billion of
that sum, 24 and federal government expenditures for Medicare to $27.4
billion. 25 Further tobacco-related consequences include productivity losses,
adding up to a value of yearly $97 billion per year over the same period. 26
This amount only includes the losses from shortened productive work lives
due to smoking-caused premature deaths. The economic costs mentioned so
far sum up to – and this was only in 1999 – $3,391 annually for every
smoking adult. 27
On top of that, productivity losses that are harder to measure must be
included, such as costs from smoking-caused disabilities, absenteeism, and
productivity declines. For instance, smoking workers accumulate almost
twice the average annual absenteeism of never-smokers ( 6.0 instead of 3. 2
days). 28 The likeliness of smoking workers to have work limitations
reducing their productivity is twice as high as for never-smokers ( 6.2% to
3%). 29 Smoking workers tend to take more frequent and longer breaks than
non-smokers, further contributing to declining productivity. 30
Further costs accrue from social security survivors insurance for the
20. U.S. DEP’T OF HEALTH AND HUMAN SERV. supra note 18, at 43.
21. Ctrs. for Disease Control and Prevention, Vital Signs: Current Cigarette Smoking
Among Adults Aged ≥ 18 Years – United States, 2005-2010, 60 MORBIDITY & MORTALITY
WKLY. REP. 1207, 1208 (2011).
22. See generally U.S. DEP’T OF HEALTH AND HUMAN SERV. supra note 18, at 863-71.
23. CDC, supra note 2, at 1228.
24. See CDC, SUSTAINING STATE PROGRAMS FOR TOBACCO CON TROL: DATA HIGHLIGHTS
2006 16-17 (2006), available at http://www.cdc.gov/tobacco/data_statistics/state_data/
25. JESSICA GUILFOYLE, THE TOLL OFTOBACCO IN THE UNITED STATES OFAMERICA 1
(2012), available at http://www.tobaccofreekids.org/research/factsheets/pdf/0072.pdf.
26. CDC, supra note 2, at 1228. See also William B. Bunn III et al., Effect of Smoking
Status on Productivity Loss, 48 J. OCCUP. ENVIRON. MED. 1099 passim (2006).
27. See CDC, supra note 15, at 300-01.
28. UNITED STATES DEPARTMENT OF HEALTH AND HUMAN SERVICES, CDC, NATIONAL
CENTER FOR HEALTH STATISTICS, NATIONAL HEALTH INTERVIEW SURVEY 2006 (2006).
30. Steve Parrott, Christine Godfrey, Martin Raw, Costs of Employee Smoking in the
Workplace in Scotland, 9 TOBACCO CONTROL 187, 187 (2000).