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A Model for Estimating the Economic Impact of Secondhand Smoke Exposure: A Study in Indiana

Saywell, Robert M. Jr PhD, MPH; Zollinger, Terrell W. DrPH; Lewis, Cynthia K. MPH; Jay, Stephen J. MD; Spitznagle, Miranda H. MPH

Journal of Public Health Management & Practice: November/December 2013 - Volume 19 - Issue 6 - p E10–E19
doi: 10.1097/PHH.0b013e3182893df9
Original Articles

Objective: This study estimated the economic cost of health services and premature loss-of-life costs from secondhand smoke (SHS) exposure in Indiana.

Design and Setting: Costs of SHS-related mortality and morbidity were estimated using national attributable risk values for diseases that are causally related to SHS exposure both for adults and children. Estimated direct costs included hospital inpatient costs, loss-of-life costs, and ambulatory care costs where available, based on the most currently available Indiana hospital discharge data, vital statistics, census data, and nationally published research.

Participants: Attributable risk values were applied to the number of deaths and hospital discharges in Indiana in 2008 and 2010, respectively, to estimate the number of individuals impacted by SHS exposure. All cost estimates were adjusted to 2010 US dollar values.

Results: The direct cost of health care and premature loss of life in Indiana attributed to SHS was estimated to be $1.3 billion in 2010—$237.8 million in health care costs and $879.0 million in premature loss of life for adults and $89.4 million in health care costs and $98.6 million in premature loss of life for children. The estimated population for Indiana in 2010 was 6 483 802 resulting in SHS-related costs of $201 per capita.

Discussion: This study demonstrated a model that could be used to estimate the costs of health care and premature mortality from exposure to SHS at a state or local level. These data may be used to support the education of the public, community leaders, and state policy makers regarding the magnitude of the problem and the compelling need to implement interventions to better protect the health of citizens and their economic prosperity.

This article discusses a model for estimating the economic cost of health services and premature loss-of-life costs from secondhand smoke exposure in Indiana, using existing information and data.

Departments of Family Medicine (Dr Saywell and Ms Lewis) and Public Health (Drs Zollinger and Jay), Bowen Research Center, Indiana University School of Medicine; and Tobacco Prevention and Cessation Commission, Indiana State Department of Health (Ms Spitznagle), Indianapolis.

Correspondence: Robert M. Saywell Jr, PhD, MPH, Bowen Research Center, Indiana University School of Medicine, 714 N Senate St, Ste 205, Indianapolis, IN 46202 (rsaywell@iupui.edu).

The authors thank Jon E. Lewis, PhD, Director, Data Analysis Team, ERC, and Director, Indiana BRFSS at the Indiana State Department of Health, Stephen Nygaard at the Indiana State Cancer Registry, Indiana State Department of Health, and Millicent Fleming-Moran, PhD, Epidemiologist Researcher at the Marion County Public Health Department, who provided many of the statistics.

The authors report no conflicts of interest.

Copyright © 2013 Wolters Kluwer Health, Inc. All rights reserved.