Payoff for quitting smoking may take years
By Aaron Levin, Science Writer
Health Behavior News Service
12/12/03
Quitting smoking may save healthcare dollars eventually, but higher health care charges start before smokers quit and remain high for five to 10 years, according to new research.The research appears in two articles in the November/December issue of the American Journal of Health Promotion.
One study, which examined patients in a Minnesota managed care organization, found that smokers who have higher health care bills — suggesting an increased use of primary care — will try to quit smoking as a result of the cost increase, say Brian Martinson and colleagues of HealthPartners Research Foundation. This was true whether the patients were apparently healthy or had been diagnosed with diabetes, heart disease, high blood pressure or high cholesterol.
Earlier research tracked healthcare costs in former or current smokers from the point of quitting, but Martinson says his study is the first to predict smoking cessation based on recent prior health care costs. A health-related event sends a patient to the doctor’s office or hospital, incurring new charges, which may remind the patient of the consequences of smoking, Martinson says. Doctors might also think of such visits as good occasions for intervention.
“The effects observed in this study,” Martinson says, “suggest the importance of primary care physicians continuing their efforts to encourage smoking cessation among their patients.”
Previous research by other scientists has found that once people quit smoking, they continue using the health care system more and incur higher costs than people who have never smoked.
Nationally, smokers are responsible for $1,623 each in excess medical expenditures above the average and $1,760 in lost productivity. Smoking-cessation programs do pay off eventually, returning a benefit of $1.74 for every dollar expended.
But the excess medical costs from smoking don’t decrease right away, say Shirley Musich, Ph.D., of the Health Management Research Center at the University of Michigan and colleagues.
In a new study of 20,332 employees of General Motors Corporation and their spouses, Musich found that former smokers who had quit in the previous four years actually had higher charges for cancers, circulatory ailments and musculoskeletal problems than current smokers. Like Martinson, Musich says that illness may serve as a wake-up call.
“This may indicate that the medical problem may have motivated smoking cessation,” she says.
Three common chronic conditions that are not usually associated with smoking occur more often among smokers and increase costs even after they quit -- arthritis, allergies and back pain. Smoking triples the risk of frequent back pain, doubles the risk of rheumatoid arthritis and raises the risk of chronic allergies by as much as five times above that of non-smokers.
She said it took approximately five years for former smokers without chronic conditions and nearly 10 years for former smokers with chronic conditions to reduce their medical charges to levels close to those of people who never smoked.
Martinson’s work was supported by a contract from HealthPartners to HealthPartners Research Foundation.
Health Behavior News Service: (202) 387-2829 or www.hbns.org.
Interviews: Contact Christian Reese (952) 967-5304 or Christian.L.Reese@healthpartners.com.
Contact Shirley Musich at (734) 763-2462 or smusich@umich.edu.
American Journal of Health Promotion: Call (248) 682-0707 or visit www.healthpromotionjournal.com.
Center for the Advancement of Health
Contact: Ira R. Allen
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