title: Evaluation of the economic impact of California's Tobacco Control Program: a dynamic model approach.
abstract: OBJECTIVE
  To evaluate the long-term net economic impact of the California Tobacco Control Program.
  
  
  METHODS
  This study developed a series of dynamic models of smoking-caused mortality, morbidity, health status and healthcare expenditures. The models were used to evaluate the impact of the tobacco control programme. Outcomes of interest in the evaluation include net healthcare expenditures saved, years of life saved, years of treating smoking-related diseases averted and the total economic value of net healthcare savings and life saved by the programme. These outcomes are evaluated to 2079. Due to data limitations, the evaluations are conducted only for men.
  
  
  RESULTS
  The California Tobacco Control Program resulted in over 700,000 person-years of life saved and over 150,000 person-years of treatment averted for the 14.7 million male California residents alive in 1990. The value of net healthcare savings and years of life saved resulting from the programme was $22 billion or $107 billion in 1990 dollars, depending on how a year of life is discounted. If women were included, the impact would likely be much greater.
  
  
  CONCLUSIONS
  The benefits of California's Tobacco Control Program are substantial and will continue to accrue for many years. Although the programme has resulted in increased longevity and additional healthcare resources for some, this impact is more than outweighed by the value of the additional years of life. Modelling the programme's impact in a dynamic framework makes it possible to evaluate the multiple impacts that the programme has on life, health and medical expenditures.
authors.affiliation: School of Social Welfare, University of California, Berkeley, California, USA.
authors.forename: Leonard S
authors.initials: LS
authors.lastname: Miller
authors.forename: Wendy
authors.initials: W
authors.lastname: Max
authors.forename: Hai-Yen
authors.initials: HY
authors.lastname: Sung
authors.forename: Dorothy
authors.initials: D
authors.lastname: Rice
authors.forename: Malcolm
authors.initials: M
authors.lastname: Zaretsky
mesh_terms: D002140:California / Q000453:epidemiology; D017048:Health Care Costs; D006293:Health Promotion / Q000191:economics*; D006801:Humans; D008136:Longevity; D008297:Male; D017059:Models, Econometric; D009026:Mortality / Q000639:trends*; D015397:Program Evaluation; D012907:Smoking / Q000191:economics / Q000401:mortality; D000074606:Smoking Prevention; D020340:Tobacco Use Cessation / Q000191:economics* / Q000706:statistics & numerical data; D014026:Nicotiana
references.citation: Cancer Epidemiol Biomarkers Prev. 1993 Nov-Dec;2(6):593-7
references.pmid: 8268779
references.citation: Ann Epidemiol. 2002 Apr;12(3):141-50
references.pmid: 11897171
references.citation: Tob Control. 2007 Apr;16(2):85-90
references.pmid: 17400944
references.citation: Cancer Causes Control. 2004 Sep;15(7):689-95
references.pmid: 15280627
references.citation: Am J Public Health. 2002 Jun;92(6):990-6
references.pmid: 12036794
references.citation: Am J Health Promot. 2000 Nov-Dec;15(2):81-8
references.pmid: 11194699
references.citation: Public Health Rep. 1998 Sep-Oct;113(5):447-58
references.pmid: 9769770
references.citation: PLoS Med. 2008 Aug 26;5(8):e178
references.pmid: 18752344
references.citation: Milbank Q. 1992;70(1):81-125
references.pmid: 1588892
references.citation: MMWR Morb Mortal Wkly Rep. 1994 Jul 8;43(26):469-72
references.pmid: 8007931
references.citation: JAMA. 1989 Mar 17;261(11):1604-9
references.pmid: 2918654
references.citation: J Natl Cancer Inst. 1996 Dec 4;88(23):1748-58
references.pmid: 8944005
references.citation: Tob Control. 2004 Sep;13(3):264-7
references.pmid: 15333882
references.citation: Annu Rev Public Health. 2002;23:45-71
references.pmid: 11910054
references.citation: Tob Control. 1999 Autumn;8(3):290-300
references.pmid: 10599574
references.citation: Health Aff (Millwood). 1996 Spring;15(1):58-72
references.pmid: 8920569
references.citation: J Health Econ. 2003 Sep;22(5):843-59
references.pmid: 12946462
references.citation: BMJ. 2004 Jun 26;328(7455):1519
references.pmid: 15213107
references.citation: JAMA. 1994 Feb 23;271(8):608-11
references.pmid: 8301793
references.citation: Am J Public Health. 2002 Jun;92(6):975-83
references.pmid: 12036792
references.citation: Soc Sci Med. 1999 Feb;48(3):375-91
references.pmid: 10077285
references.citation: N Engl J Med. 1997 Oct 9;337(15):1052-7
references.pmid: 9321534
references.citation: Soc Sci Med. 1983;17(23):1907-14
references.pmid: 6419350
references.citation: JAMA. 1998 Sep 9;280(10):893-9
references.pmid: 9739973
references.citation: MMWR Morb Mortal Wkly Rep. 1995 Jul 21;44(28):521-5
references.pmid: 7603427
references.citation: Tob Control. 1997 Summer;6(2):122-7
references.pmid: 9291221
references.citation: Am J Health Promot. 2001 May-Jun;15(5):321-31
references.pmid: 11502013
references.citation: Am J Epidemiol. 1994 Sep 15;140(6):535-43
references.pmid: 8067347
references.citation: N Engl J Med. 2000 Dec 14;343(24):1772-7
references.pmid: 11114317
references.citation: Tob Control. 2006 Aug;15(4):308-16
references.pmid: 16885580
references.citation: Hum Genet. 1981;59(1):39-46
references.pmid: 10819020
references.citation: J Gerontol A Biol Sci Med Sci. 2003 Jun;58(6):566-72
references.pmid: 12807930