Stronger anti-smoking laws could save states millions

Tougher tobacco control laws could reduce smoking-related deaths and save more than $1.3 billion in tobacco-associated health care costs in 27 states without broad smoking bans in place, according to a June study by the American Cancer Society Cancer Action Network.

The state-by-state analysis looked at the potential public health and economic impact of what the organization considers comprehensive laws that bar smoking in all types of workplaces, restaurants and bars. Twenty-three states and the District of Columbia have such legislation in place.

If the remaining 27 states with weaker or no anti-smoking laws expanded their policies, total smoking-related deaths would drop by 624,000 over time, the ACS study found. Over five years, states could save millions in health care costs to treat smoking-related diseases, including $316.1 million for lung cancer, $875.6 million for heart attacks and $42.8 million for strokes. Another $128.3 million could be saved for treatment of smoking-related pregnancy complications.

In addition, nearly 400,000 fewer youths would take up smoking, according to the report, conducted with help from the Institute for Health Research and Policy at the University of Illinois, Chicago.

The estimates were based on Centers for Disease Control and Prevention data on smoking prevalence and mortality rates, state Medicaid spending data and various other surveys of medical care costs, smoker behaviors and cigarette pricing.

"When you consider tobacco use remains the No. 1 cause of preventable death, costing $96 billion in direct health care costs each year, it's obvious [these policies] can have an impact on the overall health care system," said Cathy Callaway, associate director of state and local campaigns for the ACS Cancer Action Network, a nonpartisan lobbying arm of the organization.

In a second study, experts found that increased tobacco taxes helped curb tobacco use and deaths among youths and adults and provided revenue to mitigate treatment costs associated with smoking-related diseases. Researchers estimated that a $1-per-pack tax increase in all 50 states could yield $645 million in health care cost savings over five years.

In 2011, cigarette taxes ranged from 17 cents per pack in Missouri to $4.35 per pack in New York, according to ACS data.

American Medical Association policy supports increased local, state and federal excise taxes on tobacco to discourage use. The AMA also encourages state medical societies to support local legislation mandating smoke-free workplaces and other public areas.

The studies could provide ammunition to legislators looking to toughen state anti-smoking policies, Callaway said.

"This shows that these are two policy interventions that work and that decision-makers and lawmakers can put into place and truly have an impact on public health and health care cost savings," she said.

The report is online (link).