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The annual tobacco-related health care spend of US Minorities who smoke is double that of white adults who smoke, finds an analysis of national health and medical spend survey data, published online in the journal Tobacco Control.
And the excess risks of three or more long-term health conditions associated with smoking are more than 40% higher among Minority adults, despite their lower smoking rates and more numerous quit attempts than their White peers, the analysis indicates.
The findings prompt the researchers to conclude that Minority adults who smoke stand to benefit substantially more from tobacco control policies than do white adults who smoke.
Every year, 480,000 people die prematurely from diseases linked to smoking, making tobacco use the leading cause of preventable illness and death in the U.S., note the researchers.
In 2022, the US Food and Drug Administration proposed regulations that would set a maximum nicotine level to help reduce the addictiveness of cigarettes and stop an estimated 33 million people from smoking by 2100.
But this type of far-reaching regulation requires the Office of Management and Budget (OMB)—the office that assists the US President to develop and execute policies–to prove that the benefits would outweigh the costs.
And, earlier this year, the President requested that cost-benefit analyses for new tobacco control regulations should account for their impact on different sectors of the population.
For the first time, therefore, the researchers estimated the racial and ethnic disparities in medical spending and health outcomes associated with smoking in the US.
They linked data from the 2008–19 Medical Expenditure Panel Survey (Household Component) and the National Health Interview Survey for 118, 084 adults to estimate the proportion of the top 10 health conditions and annual health care spend—adjusted for inflation—attributable to smoking by race and ethnicity.
Between 2008 and 2019, 15% of Minority adults smoked, compared with 17% of white adults, who smoked the most cigarettes every day: 14 vs. 9.
While the proportion of white adults trying to quit smoking fell to 53% in 2019, this increased to 63% for Minorities.
Tobacco-related health issues accounted for just under 12% of the total yearly medical care spend ($876 out of $7,208) for white adults who smoked, but were twice as much—25% ($1,509 of the $6,253)—-for Minority adults who smoked, primarily driven by Hispanic and other racial groups.
Minority adults were also significantly more likely to have three or more of the top 10 conditions associated with smoking in the US: high cholesterol; high blood pressure; diabetes; joint pain; cancer; heart attack; arthritis; asthma; heart disease; and stroke. They were 34% more likely to do so compared with 24% for white adults who smoked.
Between 2008 and 2016, smoking comprised 7.5% of the nation’s total health care spending for White adults and nearly 11% for Minority adults.