Smoking-Attributable Mortality, Years of Potential Life Lost, and Productivity Losses

Adhikari, Bishwa B.; Kahende, Jennifer; Malarcher, Ann; Pechacek, Terry F.; Tong, Van T.

doi:10.1097/01.cot.0000345498.34913.fd

Cited by 74 publications

(87 citation statements)

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“…For example, smoking currently costs the U.S. about $193 billion annually-$97 billion from lost productivity and about $96 billion in healthcare costs. 21,22 The total direct and indirect cost of physical inactivity was estimated to be in excess of $150 billion in 2000. 23 Comparing the 2006 estimates to those from 1992 and 1998 3,4 is problematic because there were several methodologic differences among the studies (e.g., different attribution factors, data sources, categories of expense [new ones such as absenteeism and old ones that were removed such as social welfare], disease conditions considered, approach to comorbidity, FAS prevalence, valuing of inmate time, and discount rate).…”

Section: Discussionmentioning

confidence: 99%

Economic Costs of Excessive Alcohol Consumption in the U.S., 2006

Bouchery

Harwood

Sacks³

et al. 2011

American Journal of Preventive Medicine

771

538

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Background: Excessive alcohol consumption causes premature death (average of 79,000 deaths annually); increased disease and injury; property damage from fıre and motor vehicle crashes; alcohol-related crime; and lost productivity. However, its economic cost has not been assessed for the U.S. since 1998.Purpose: To update prior national estimates of the economic costs of excessive drinking.Methods: This study (conducted 2009 -2010) followed U.S. Public Health Service Guidelines to assess the economic cost of excessive alcohol consumption in 2006. Costs for health care, productivity losses, and other effects (e.g., property damage) in 2006 were obtained from national databases. Alcohol-attributable fractions were obtained from multiple sources and used to assess the proportion of costs that could be attributed to excessive alcohol consumption. Results:The estimated economic cost of excessive drinking was $223.5 billion in 2006 (72.2% from lost productivity, 11.0% from healthcare costs, 9.4% from criminal justice costs, and 7.5% from other effects) or approximately $1.90 per alcoholic drink. Binge drinking resulted in costs of $170.7 billion (76.4% of the total); underage drinking $27.0 billion; and drinking during pregnancy $5.2 billion. The cost of alcohol-attributable crime was $73.3 billion. The cost to government was $94.2 billion (42.1% of the total cost), which corresponds to about $0.80 per alcoholic drink consumed in 2006 (categories are not mutually exclusive and may overlap).Conclusions: On a per capita basis, the economic impact of excessive alcohol consumption in the U.S. is approximately $746 per person, most of which is attributable to binge drinking. Evidencebased strategies for reducing excessive drinking should be widely implemented. (Am J Prev Med 2011;41(5):516 -524)

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Section: Discussionmentioning

confidence: 99%

Economic Costs of Excessive Alcohol Consumption in the U.S., 2006

Bouchery

Harwood

Sacks³

et al. 2011

American Journal of Preventive Medicine

771

538

View full text Add to dashboard Cite

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“…Cigarette smoking is a significant cause of premature death and disease 1 . Successfully quitting and maintaining abstinence reduce risks to smokers [2][3][4] .…”

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confidence: 99%

Personalized Smoking Cessation: Interactions between Nicotine Dose, Dependence and Quit-Success Genotype Score

Rose

Behm

Drgon

et al. 2010

Mol Med

131

104

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Improving and targeting nicotine replacement therapy (NRT) are cost-effective strategies for reducing adverse health consequences for smokers. Treatment studies document the efficacy of pre-cessation NRT and support important roles for level of nicotine dependence and pre-cessation smoking reduction in successful quitting. However, prior work has not identified the optimal pre-cessation dose or means for personalizing NRT. Genome wide association has identified groups of genomic markers that are associated with successful quitting, allowing us to develop a v1.0 "quit success" genotype score. We now report influences of v1.0 quit success genotype score, level of dependence and pre-cessation smoking reduction in a smoking cessation trial that examined effects of 21 vs 42 mg/24 h pre-cessation NRT. 479 smokers were randomized to 21 or 42 mg NRT, initiated 2 weeks prior to target quit dates.We monitored self-reported abstinence and end-expired air carbon monoxide (CO). Genotyping used Affymetrix arrays. The primary outcome was 10-week continuous smoking abstinence. NRT dose, level of nicotine dependence and genotype scores displayed significant interactive effects on successful quitting. Successful abstinence was also predicted by CO reductions during pre-cessation NRT. These results document ways in which smoking cessation strategies can be personalized based on levels of nicotine dependence, genotype scores and CO monitoring. These assessments, taken together, can help to match most smokers with optimal NRT doses and to rapidly identify some who may be better treated using other methods. Molecular Medicine www.molmed.org UNCORRECTED PROOFCigarette smoking is a significant cause of premature death and disease 1 . Successfully quitting and maintaining abstinence reduce risks to smokers [2][3][4] . However, success rates following attempts to quit smoking remain modest. One year after unaided attempts to quit smoking, abstinence rates are less than 5% 5,6 . Even with pharmacologic aids that include nicotine replacement therapy (NRT), bupropion and varenicline, long-term abstinence rates are less than 25% 7, 8 .Pre-cessation NRT initiates nicotine patch treatment two weeks prior to a target quit date 9, 10 . The 21 mg/24 hour dose pre-cessation dose used to date is well tolerated by most smokers 9, 10 and consistently enhances quit rates: recent meta-analyses show a 1.8-2.2 fold greater likelihood of success than conventional NRT 11,12 . However, neither dose/response data nor clear-cut recommendations for personalizing pre-cessation NRT have been reported.More effective smoking cessation might result from personalizing existing treatments based on characteristics of individual smokers. Previous research has identified phenotypic and genotypic variables that might aid in predicting likelihood of success in smoking cessation and/or differential responses to different treatment regimens. In smoking cessation trials, smokers who score higher on the Fagerström Test for Nicotine Dependence (FTND), and thus display ...

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“…Cigarette smoking is a significant cause of premature death and disease (1). Although abstinence reduces risks to smokers, success rates after attempts to quit smoking remain modest.…”

Section: Introductionmentioning

confidence: 99%

Genome-Wide Association for Smoking Cessation Success in a Trial of Precessation Nicotine Replacement

Uhl

Drgon

Johnson

et al. 2010

Mol Med

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Abilities to successfully quit smoking display substantial evidence for heritability in classic and molecular genetic studies. Genomewide association (GWA) studies have demonstrated single-nucleotide polymorphisms (SNPs) and haplotypes that distinguish successful quitters from individuals who were unable to quit smoking in clinical trial participants and in community samples. Many of the subjects in these clinical trial samples were aided by nicotine replacement therapy (NRT). We now report novel GWA results from participants in a clinical trial that sought dose/response relationships for "precessation" NRT. In this trial, 369 European-American smokers were randomized to 21 or 42 mg NRT, initiated 2 wks before target quit dates. Ten-week continuous smoking abstinence was assessed on the basis of self-reports and carbon monoxide levels. SNP genotyping used Affymetrix 6.0 arrays. GWA results for smoking cessation success provided no P value that reached "genome-wide" significance. Compared with chance, these results do identify (a) more clustering of nominally positive results within small genomic regions, (b) more overlap between these genomic regions and those identified in six prior successful smoking cessation GWA studies and (c) sets of genes that fall into gene ontology categories that appear to be biologically relevant. The 1,000 SNPs with the strongest associations form a plausible Bayesian network; no such network is formed by randomly selected sets of SNPs. The data provide independent support, based on individual genotyping, for many loci previously nominated on the basis of data from genotyping in pooled DNA samples. These results provide further support for the idea that aid for smoking cessation may be personalized on the basis of genetic predictors of outcome. nominally significant associations with successfully quitting in other studies of smoking cessation. We identify specific gene ontology classes into which candidate "quit success" genes (that are identified in these analyses) fall more often than expected by chance. We describe a Bayesian network into which the quit success-associated SNPs fall. MATERIALS AND METHODS SubjectsAdult smokers who expressed desires to quit were recruited and screened at one of four North Carolina centers. Participants provided written informed consent; reported smoking an average of ≥10 cigarettes/day that each yielded ≥0.5 mg nicotine; displayed end-expired air carbon monoxide (CO) ≥10 ppm; failed to display any exclusionary features on history, physical examination or laboratory evaluations; and were compensated up to $140. Smokers were subdivided into low-and high-dependence subgroups (Fagerström Test for Nicotine Dependence [FTND] scores ≤6 or >6, respectively), and individuals in each of these subgroups were randomly assigned to 21 mg/24 h or 42 mg/24 h nicotine patch doses. During seven study sessions, brief supportive counseling was provided, clinical trial materials were dispensed and dependent measures were assessed. Dependent measures included measured en...

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Smoking-Attributable Mortality, Years of Potential Life Lost, and Productivity Losses

Cited by 74 publications

References 0 publications

Economic Costs of Excessive Alcohol Consumption in the U.S., 2006

Economic Costs of Excessive Alcohol Consumption in the U.S., 2006

Personalized Smoking Cessation: Interactions between Nicotine Dose, Dependence and Quit-Success Genotype Score

Genome-Wide Association for Smoking Cessation Success in a Trial of Precessation Nicotine Replacement

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