Tobacco Prevention Programs are Proven to Reduce Smoking

Extensive research on the experiences of other states makes it clear that renewing funding for DCTFF would significantly prevent and reduce smoking and other tobacco use in the District and produce enormous public health and economic benefits.

Most fundamentally, it is well established that comprehensive tobacco prevention programs consistent with CDC guidelines prompt substantial reductions in smoking levels among both adults and kids. This is achieved by both increasing the number of people who quit or cutback smoking and reducing the numbers who start. In addition, studies have shown that the more that is spent on tobacco prevention, the lower the youth smoking rates and overall tobacco use. As a result, state tobacco prevention programs also reduce all the death, disease, disability and other harms caused by smoking and other tobacco use – and also save money by reducing tobacco-related health care costs.
National studies that look across states and control for as many of the relevant confounding factors as possible consistently show powerful, positive effects of tobacco prevention and cessation programs. For example:

A recent study published in the American Journal of Public Health examined state tobacco prevention and cessation funding levels from 1995 to 2003 and found that the more states spent on these programs, the larger the declines they achieved in adult smoking, even when controlling for other factors such as increased tobacco prices. The researchers also calculated that if every state had funded their programs at the levels recommended by the CDC during that period, there would have been between 2.2 million and 7.1 million fewer smokers in the United States by 2003. The Campaign for Tobacco-Free Kids estimates that such smoking declines would have saved between 700,000 and 2.2 million lives as well as between $20 billion and $67 billion in health care costs.

The study described above adds to earlier research, using similar methods, which demonstrated the same type of relationship between program spending and youth smoking declines. The 2005 study concluded that if every state had spent the minimum amount recommended by the CDC for tobacco prevention, youth smoking rates nationally would have been between 3 percent and 14 percent lower during the study period, from 1991 to 2000. Further, if every state funded tobacco prevention at CDC minimum levels, states would prevent nearly two million kids alive today from becoming smokers, save more than 600,000 of them from premature, smoking-caused deaths, and save $23.4 billion in long-term, smoking-related health care costs.

In 2007, the Institute of Medicine and the President’s Cancer Panel each issued separate landmark reports that reviewed available data, research, and other evidence and concluded that comprehensive state tobacco control programs substantially reduce smoking and other tobacco use among both adults and youth. Accordingly, both the Institute of Medicine and the President’s Cancer Panel recommended that every state adequately fund their tobacco prevention programs at the CDC-recommended levels.

Over time, more evidence has accumulated on the power of investments in tobacco prevention and cessation to produce massive public health and economic benefits. For example, earlier studies had found that state tobacco prevention programs can, in their early years, save $3 or more just from reduced state health care expenditures for every dollar spent. New research has added to these findings and shows that state programs secure even larger returns on investment for sustained funding of tobacco prevention at adequate levels over 10 or more years. Most notably, a new study of California’s tobacco prevention program found that for every dollar the state spent on its tobacco control program from 1989 to 2004, the state received tens of dollars in savings in the form of sharp reductions to total health care costs in the state. This study confirms that the cost-saving benefits from sustained state investments in effective tobacco control programs quickly grow over time to dwarf the state expenditures, producing massive gains for the state not only in terms of both improved public health and increased worker productivity but in reduced government, business, and household costs.

Similarly, an August 2008 study from Australia found that for every dollar spent on a strong tobacco control program there (consisting primarily of aggressive anti-smoking television ads along with telephone quitlines and other support services to help smokers quit) the program reduced future healthcare costs by $70 over the lifetimes of the persons the program prompted to quit. This savings estimate was based on the study’s finding that for every 10,000 people who quit because of the tobacco control program, more than 500 people were saved from lung cancer, more than 600 people escaped having heart attacks, at least 130 people avoided suffering from a stroke, and more than 1,700 people were prevented from suffering from chronic obstructive pulmonary disease (COPD).

Substantial cost savings from getting adult smokers to quit begin to appear as soon as the smoking declines occur. Research studies estimate that the direct additional health care costs in the United States associated just with the birth complications caused by pregnant women smoking or being exposed to secondhand smoke could be as high as $2 billion per year or more, with the costs linked to each smoking-affected birth averaging $1,142 to $1,358.13 And state Medicaid programs cover well over half of all births in the United States. Sharp drops in the major smoking-caused diseases and the large related savings, do not appear for several years after state adult smoking levels decline, but some small declines in these smoking-caused diseases do begin to occur immediately, with significant cost savings. In California, for example, the state tobacco control program’s reductions to adult smoking in its first seven years produced healthcare costs savings of $390 million just through the related declines in smoking-caused heart attacks and strokes, with more than $25 million of those savings appearing in just the first two years. In addition, while most of the health care savings from getting kids to quit smoking or never start do not appear until years later, some savings from reducing youth smoking also appear immediately.

By quickly reducing the number of cigarettes smoked by adults and kids each year, tobacco-control programs also reduce other health problems and related costs caused by secondhand smoke. Adults and children with emphysema, asthma, or other respiratory illnesses, for example, can suffer immediate distress from being exposed to cigarette smoke, which can even lead to hospitalization in some cases.
Reducing the number of cigarettes smoked can also reduce the number of smoking-caused fires and the amount of smoking-caused smoke damage, soiling, and litter. While no good estimates of the related cost savings exist, smoking-caused fires cause more than $500 million in residential and commercial property losses each year; and business maintenance and cleaning costs caused by smoking annually total roughly $5 billion nationwide.