Pubdate: Wed, 9 Sep 1998 Source: Reuters Author: Andrew Quinn SICK SMOKERS COST U.S. $73 BILLION PER YEAR - STUDY SAN FRANCISCO (Reuters) - It costs almost $73 billion per year to treat U.S. smokers for medical problems caused by cigarettes -- a figure which dwarfs proposed settlements with the tobacco industry, according to a study released Wednesday. Health economists at the University of California went through published figures for all public and private health care spending and determined that cigarette smoking accounted for about 11.8 percent of total U.S. medical expenditures in 1993, totaling $72.7 billion. ``This is higher than was estimated in the past, and we think that we have used better data, and better modeling to come up with these higher costs,'' said report co-author Dorothy Rice of the Institute for Health and Aging at the University of California-San Francisco. The new research, published in the September issue of Public Health Reports, indicates that smoking-related illnesses cost the United States far more than just the estimated $12.9 billion spent in 1993 by Medicaid, the state-federal health care program for the poor. It also estimates a far higher total cost than the $50 billion projected by an earlier research study, a difference Rice and her colleagues attributed to more precise statistical analysis. According to official figures, roughly 23 percent of Americans smoke, ranging from a high of more than 30 percent of Kentucky adults to a low of 16 percent of adults in Utah. The report analyzed health care data for each of the 50 U.S. states and found that California spent the most money treating its smokers with health care costs reaching about $9 billion, including about $1.7 billion in Medicaid payments. New York followed with $6.6 billion in medical costs, while Wyoming spent the least at just $80 million per year. Taken as a whole, however, the costs of treating sick U.S. cigarette smokers over a number of years are far larger than the proposed -- and aborted -- $368.5 billion settlement the states' attorneys general negotiated last year in a deal with the tobacco industry. That agreement, originally intended to compensate states for their smoking-related Medicaid costs, was widely criticized by health groups and politicians who felt it was too lenient on the tobacco companies, and eventually fell apart after Congress refused to back it. Now, new dealings are underway between a number of states and representatives of the tobacco companies. So far, Mississippi, Florida, Texas and Minnesota have reached such deals worth a total of $36 billion. But Rice said the new research indicated the states might not be asking for enough. ``Most of the states have just been suing the tobacco industry to recoup the Medicaid costs,'' Rice said. ``Having the total picture really indicates that there are additional costs to Medicaid that have not been accounted for.'' Minnesota, for example, this month took the first payment of a record $6.17 billion settlement with the tobacco companies. But Rice's report shows that Minnesota spends a total of about $1.2 billion per year treating sick cigarette smokers -- meaning the tobacco pay-off will run out long before the state's supply of sick smokers. ``My feeling is that we really must strive to be a smoke-free society in order to hold down our costs,'' Rice said. ''We must convince our children not to take up smoking, not to become addicted...and thereby not be subject to the health hazards associated with smoking.'' - --- Checked-by: Patrick Henry