title: A model for estimating the economic impact of secondhand smoke exposure: a study in Indiana.
abstract: OBJECTIVE
  This study estimated the economic cost of health services and premature loss-of-life costs from secondhand smoke (SHS) exposure in Indiana.
  
  
  METHODS
  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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: 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.
authors.forename: Robert M
authors.initials: RM
authors.lastname: Saywell
authors.forename: Terrell W
authors.initials: TW
authors.lastname: Zollinger
authors.forename: Cynthia K
authors.initials: CK
authors.lastname: Lewis
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Jay
authors.forename: Miranda H
authors.initials: MH
authors.lastname: Spitznagle
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003365:Costs and Cost Analysis; D005260:Female; D005102:Health Expenditures / Q000639:trends; D006760:Hospitalization / Q000191:economics; D006801:Humans; D007196:Indiana; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D009017:Morbidity; D009026:Mortality / Q000639:trends; D061213:Mortality, Premature / Q000639:trends; D014028:Tobacco Smoke Pollution / Q000191:economics*
chemical_list: D014028:Tobacco Smoke Pollution