Evaluation of the economic impact of California's Tobacco Control Program: a dynamic model approach

Abstract

ObjectiveTo evaluate the long-term net economic impact of the California Tobacco Control Program.MethodsThis study developed a series of dynamic models of smoking-caused mortality, morbidity, health status and healthcare expenditures. The models were used to evaluate the impact of the tobacco control programme. Outcomes of interest in the evaluation include net healthcare expenditures saved, years of life saved, years of treating smoking-related diseases averted and the total economic value of net healthcare savings and life saved by the programme. These outcomes are evaluated to 2079. Due to data limitations, the evaluations are conducted only for men.ResultsThe California Tobacco Control Program resulted in over 700 000 person-years of life saved and over 150 000 person-years of treatment averted for the 14.7 million male California residents alive in 1990. The value of net healthcare savings and years of life saved resulting from the programme was $22 billion or $107 billion in 1990 dollars, depending on how a year of life is discounted. If women were included, the impact would likely be much greater.ConclusionsThe benefits of California's Tobacco Control Program are substantial and will continue to accrue for many years. Although the programme has resulted in increased longevity and additional healthcare resources for some, this impact is more than outweighed by the value of the additional years of life. Modelling the programme's impact in a dynamic framework makes it possible to evaluate the multiple impacts that the programme has on life, health and medical expenditures.

The impact of changes in tobacco control funding on healthcare expenditures in California, 2012–2016

“…It is possible that a successful tobacco control program will result in greater longevity among quitters and smokers who smoke fewer cigarettes. This could potentially have a different impact on healthcare expenditures in the long run, as might any intervention that leads to longer life 26. Finally, our estimates are point estimates and do not account for the sampling variability in the estimation and projection of smoking prevalence or healthcare expenditures.…”

The net effect of smoking on healthcare and welfare costs. A cohort study

“…The costs of smoking to society have been modelled by using estimates on increased mortality and morbidity. [6][7][8][9][10][11][12][13][14][15][16][17][18] However, none of these modelling studies investigated the overall net economic effect of smoking on public finance balance by using actual data from individuals, and only a few had taken into account all the following factors; lifetime productivity or income taxes and pension fees paid, pension costs, and a monetary value of life years lost. 17 18 Our results indicate that combined, these factors make a considerable contribution to the overall net effect than merely healthcare costs which is in line with the modelling studies by Sloan et al 17 and Viscosi.…”

“…[6][7][8][9][10][11][12][13][14][15][16][17][18] Some modelling studies have suggested that although smokers suffer more ARTICLE SUMMARY Article focus ▪ No results have been obtained from prospective individual level data based on mortality, morbidity, pension and healthcare costs and, therefore, the net economic impact of smoking on society has remained unclear.…”

Impact of Broadened Coverage of Smoking Cessation Treatments on Cardiovascular Disease

“…California, which has the nations’ third lowest smoking prevalence rate due in part to greater tax induced cigarette prices and effective media campaigns is one prominent example of the impact that these efforts can have. [28] California’s model does not distinguish between primary and secondary prevention but the coordinated and multi-faceted program is a model for other states considering similar efforts to reduce smoking prevalence.…”

“…While the ACA empowers the federal government to establish exchanges when a state chooses not to, expanded insurance coverage within states that have federally sponsored exchanges is less likely to be integrated with other initiatives such as higher cigarette taxes and media campaigns. This coordinated approach of combining insurance access to evidence based programs, cigarette taxes and media campaigns, such has been used in California,[28,62,63] is likely critical to efforts to reduce smoking rates and states with the highest prevalence of smoking and the most challenging socio-demographic factors are less likely to follow the California model.…”