Chronic Lower Respiratory Disease (CLRD) remains a significant public health concern, exacerbated by cigarette smoking, which leads to worsened symptoms and higher health care costs. This study delves into the economic ramifications of smoking among adults with CLRD in the United States, focusing on health care expenditures attributable to cigarette use. By analyzing data from national surveys, the research offers a comprehensive look at how smoking status correlates with health care spending in different age groups.
Study Design and Population
Data from the 2014-2018 and 2020 National Health Interview Surveys (NHIS) and the 2020 Medical Expenditure Panel Survey were utilized in this cross-sectional study. The study population comprised adults aged 35 to 64 and those aged 65 and older, extracted from the NHIS dataset. The categorization of smoking status included current smokers, former smokers who quit less than 15 years ago, former smokers who quit 15 or more years ago, and never smokers.
Health Care Expenditures
The main focus was on smoking-attributable health care expenditures (SAHEs), assessed through a prevalence-based annual cost approach. Econometric models were employed to link cigarette smoking with health care utilization across four types of services: inpatient care, emergency department visits, physician visits, and home health visits.
Results indicated that among adults aged 35 to 64 with CLRD, 31.3% were current smokers, and 31.2% were former smokers. Total SAHEs for this age group in 2020 amounted to $13.6 billion, averaging $2752 per current smoker and $1083 per former smoker. For those aged 65 and older, 19.2% were current smokers, and 54.3% were former smokers, with total SAHEs of $5.3 billion, averaging $1704 per current smoker and $682 per former smoker.
Key Inferences
- Targeted smoking cessation programs could significantly reduce health care costs for current smokers with CLRD.
- Former smokers incur lower health care expenditures, underscoring the financial benefits of quitting smoking.
- Age-specific interventions may be necessary to address the distinct smoking patterns and health care needs of younger and older adults with CLRD.
In 2020, the total SAHEs for adults with CLRD aged 35 years or older reached a staggering $18.9 billion. The data suggest that smoking cessation efforts could yield substantial economic savings by reducing the health care burden associated with smoking-related complications in CLRD patients.
The findings underscore the importance of developing and implementing effective smoking cessation strategies tailored to adults with CLRD, potentially leading to significant cost savings and improved health outcomes.
Original Article: JAMA Netw Open. 2024 May 1;7(5):e2413869. doi: 10.1001/jamanetworkopen.2024.13869.
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