The disproportionate cost of smoking for African Americans in California.
OBJECTIVE
We estimated the economic impact of smoking on African Americans in California in 2002, including smoking-attributable health care expenditures and productivity losses from smoking-caused mortality.


METHODS
We estimated econometric models of smoking-attributable ambulatory care, prescription drugs, inpatient care, and home health care using national and state survey data. We assessed smoking-attributable mortality using epidemiological models.


RESULTS
Adult smoking prevalence for African Americans was 19.3% compared with 15.4% for all Californians. The health care cost of smoking was $626 million for the African American community. A total of 3013 African American Californians died of smoking-attributable illness in 2002, representing a loss of over 49,000 years of life and $784 million in productivity. The total cost of smoking for this community amounted to $1.4 billion, or $1.8 billion expressed in 2008 dollars.


CONCLUSIONS
Although African Americans account for 6% of the California adult population, they account for over 8% of smoking-attributable expenditures and fully 13% of smoking-attributable mortality costs. Our findings confirm the need to tailor tobacco control programs to African Americans to mitigate the disproportionate burden of smoking for this community.
Max
Wendy
W
Institute for Health and Aging, School of Nursing, 3333 California St, Suite 340, San Francisco, CA 94118, USA. wendy.max@ucsf.edu
Sung
Hai-Yen
HY
Tucker
Lue-Yen
LY
Stark
Brad
B
D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D000553:Ambulatory Care / Q000191:economics; D002140:California / Q000453:epidemiology; D011307:Drug Prescriptions / Q000191:economics; D004526:Efficiency; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006699:Home Care Services / Q000191:economics; D006760:Hospitalization / Q000191:economics; D006801:Humans; D008297:Male; D017059:Models, Econometric; D012907:Smoking / Q000191:economics* / Q000208:ethnology* / Q000401:mortality