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Journal of Occupational & Environmental Medicine:
doi: 10.1097/JOM.0b013e318246f1f4
Original Articles

The Effects of Incremental Costs of Smoking and Obesity on Health Care Costs Among Adults: A 7-Year Longitudinal Study

Moriarty, James P. MSc; Branda, Megan E. MS; Olsen, Kerry D. MD; Shah, Nilay D. PhD; Borah, Bijan J. PhD; Wagie, Amy E. BS; Egginton, Jason S. MPH; Naessens, James M. ScD

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Abstract

Objective: To provide the simultaneous 7-year estimates of incremental costs of smoking and obesity among employees and dependents in a large health care system.

Methods: We used a retrospective cohort aged 18 years or older with continuous enrollment during the study period. Longitudinal multivariate cost analyses were performed using generalized estimating equations with demographic adjustments.

Results: The annual incremental mean costs of smoking by age group ranged from $1274 to $1401. The incremental costs of morbid obesity II by age group ranged from $5467 to $5530. These incremental costs drop substantially when comorbidities are included.

Conclusions: Obesity and smoking have large long-term impacts on health care costs of working-age adults. Controlling comorbidities impacted incremental costs of obesity but may lead to underestimation of the true incremental costs because obesity is a risk factor for developing chronic conditions.

©2012The American College of Occupational and Environmental Medicine

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