This paper estimates the healthcare costs and the value of lost productivity from premature deaths for California women with breast cancer in 2001, with an updated estimate for 2008. Multiple secondary data sources were used to estimate the healthcare cost of breast cancer. Mortality costs were estimated as the product of the number of deaths and the expected value of a woman's future earnings. The total economic cost of breast cancer in California was $1.43 billion in 2001, or $1.91 billion in 2008 dollars. Breast cancer is costly both in terms of healthcare dollars and the value of lost lives. Regular screening and access to treatment for all women will allow the disease to be diagnosed earlier, the prognosis improved, and the economic burden reduced.

Despite extensive efforts at tobacco control in California, healthcare and lost productivity costs attributable to smoking remain high. Compared to costs for 1999, the total cost was 15% greater in 2009. However, after adjusting for inflation, real costs have fallen by 13% over the past decade, indicating that efforts have been successful in reducing the economic burden of smoking in the state.

Although African Americans account for 6% of the California adult population, they account for over 8% of smoking-attributable expenditures and fully 13% of smoking-attributable mortality costs. Our findings confirm the need to tailor tobacco control programs to African Americans to mitigate the disproportionate burden of smoking for this community.

Objectives. We determined smoking prevalence, smoking behavior, and secondhand smoke (SHS) exposure of LGB-identified Californians; compared these with heterosexuals; and analyzed changes over the last decade. Methods.We analyzed the 2003-2013 California Health Interview Surveys, using multivariate logistic regression models to examine the impact of sexual identity on smoking behaviors. We conducted time trend analyses for each smoking behavior.Results. Lesbian and bisexual women smoke at higher rates than heterosexual women, and female bisexual smokers were less likely to be light smokers than heterosexuals.Among men, smoking prevalence was higher among gays and bisexuals than among heterosexuals; and gay smokers were more likely to be daily smokers and bisexual smokers were more likely to be light smokers than heterosexuals. Sexual minority men and women were more likely to be exposed to SHS at home than heterosexuals.Smoking prevalence and SHS exposure have fallen among sexual minorities. Conclusions. Sexual identity disparities in smoking and SHS exposure exist inCalifornia. Bisexual women and men are particularly at risk. Interventions should consider the needs of these groups and of all sexual minority smokers.2